‘Sticky hands’ is rare psychiatric disorder

Hardly do they, or the people around them understand that they stark ill and yet, they are. Relatives, friends and colleagues brand them with infamous names like “thief” or “sticky hands” and have been severely punished for it. They are not the “career” thieves as it is assumed.

Sally* a trained journalist and well-to-do middle class woman has severally been nabbed shoplifting petty items of no value – things that she can afford at any one given time. It is said that at home, she “owns” mats, cups, towels and other items stolen from different hotels that she has visited. Her friends say that any time she sleeps over in the houses bras, underclothes, scarves and even handkerchiefs disappear in the thin air.

Anna* is a 43-year-old, married female with three children. When she first began stealing at the age of 16, she would steal something once every few weeks from the shops, friends’ homes and supermarkets. Although gainfully employed throughout her adult life, she steals unnecessary items from retail stores and from friends.

Upon entering a shop or supermarket, Anna has an overwhelming urge to steal. After leaving the store, she feels guilty for having taken the item. These stolen objects, usually small items (e.g. cosmetics, hygiene products, magazines), are placed in boxes in her garage at home, never used. Her family does not know about her problem but she does not feel proud of this fact. She feels a sense of self-loathing on a daily basis.

Juma* was arrested for stealing a life jacket from the MV Kazi ferry. Whatever for, no one knows, including himself. He has nothing to do with fishing or such activities that would requires the use of a life jacket.

Gossip tabloids are awash with stories of celebs busted for impulsive activities of stealing of items and shoplifting even though their lives seem to be full of glitz and glamour, unlimited funds in their bank accounts, luxury items, and free fashion products seems unbelievable. For some celebrities, money, and fame have not stopped the compulsion to shoplift and the thrill that they feel when trying to get away with it.

All the three cases suffer a mental illness known as kleptomania. According to Brazilian Journal of psychiatry, Kleptomania: clinical characteristics and treatment, kleptomania, is a disabling impulse control disorder characterized by the repetitive and uncontrollable urge to steal items that are of little use to the afflicted person. Despite its relatively long history, kleptomania remains poorly understood to the general public, clinicians, and sufferers.

Historically, kleptomania was not recognized as a psychiatric disorder and when it was categorized so, many viewed it as a medical disorder. Indeed, it was associated with women although it was later discovered that men also are as prone. Although no national epidemiological study of kleptomania has been performed, studies of kleptomania in various clinical samples suggest that it is not uncommon.

Kleptomania is described in both the medical and legal literatures for centuries, dating back to the early 19th century when the Swiss physician, Mathey who worked with the “insane” wrote of “a unique madness characterized by the tendency to steal without motive and without necessity. The tendency to steal is permanent but the thieving tendency triumphs, it subjugates the will.” He termed this condition as ‘klopemania’ or a ‘stealing insanity.

The journal further says that studies using clinical samples have consistently reported that the majority (approximately two-thirds) of kleptomania patients are women. Without epidemiological data, however, the true percentage of men and women with kleptomania remains unknown. Some have suggested that greater numbers of females seek treatment for kleptomania because men are more likely to be sent to jail if caught shoplifting.

Dr Praxeda Swai a Medical Specialist of Psychiatry and Mental Health at Muhimbili National Hospital, says Kleptomania is the inability to resist urges to steal items that one generally don’t really need and that usually have little value. It is rare but a serious mental health disorder that can cause much emotional pain to someone if not treated. She says that although there are no national figures, the problem does exist.

“It is a type of impulse control disorder characterized by problems with emotional or behavioural self-control. There is difficulty resisting the temptation or drive to perform an act that’s excessive or harmful to oneself or others. Kleptomania is thought to account for 5% of shoplifting. In those arrested for shoplifting the prevalence of the illness is approximated to be 3-24 percent. No studies have been done in Tanzania regarding Kleptomania, however it is estimated that 1 out of 1000 people may suffer the illness based on studies done in the western countries. The prevalence of kleptomania in the general population is approximated at 0.6 percent. In those arrested for shoplifting, the prevalence of kleptomania is 3.8 to 24 percent, she said.

She further says that compared to other psychiatric problems, kleptomania is very hard to detect since it is a disorder that lacks all the symptoms evident in other mental disorders.

“Compared to other psychiatric illnesses Kleptomania may not be easily recognized as mental illness since it lacks any other mental illness signs and symptoms like behavioral or speech disorganization, thought or even perceptual disturbances and therefore making it hard to be recognized as mental illness.

People judge the behavioral outcomes of it which is obviously stealing without understanding the uncontrollable impulse that the patient experiences. Therefore people with the illness are easily judged as thieves and in most cases legal actions are taken against them,” says the doctor.

Studies elsewhere point to the fact that more women than men suffer the condition and but no one knows the reason.

“Studies have reported that the majority (approximately two third of kleptomaniacs are women. The reason why the prevalence is higher among women is not clearly known but it could be due to the fact that greater numbers of women seek treatment while men are more likely to be sent to jail once caught stealing/shoplifting,” she added.

The cause of kleptomania is not known. Several theories suggest that changes in the brain may be at the root of kleptomania.

“Having family history of the same disorder such as a parent or sibling, with kleptomania, obsessive-compulsive disorder, or an alcoholic or other substances used that can bolster the disorder may increase the risk of kleptomania.

According to Dr Paxeda Swai, unlike typical shoplifters, people with kleptomania don’t compulsively steal for personal gain, on a dare, for revenge or out of rebellion. They steal simply because the urge is so powerful that they can’t resist it. Episodes of kleptomania generally occur spontaneously, usually without planning and without help or collaboration from another person. Most people with kleptomania steal from public places, such as stores and supermarkets. Some may steal from friends or acquaintances, such as at a party.

Often, the stolen items have no value to the person with kleptomania, and the person can afford to buy them. The stolen items are usually stashed away, never to be used. Items may also be donated, given away to family or friends, or even secretly returned to the place from which they were stolen.

“Urges to steal may come and go or may occur with greater or lesser intensity over the course of time. People with Kleptomania experience the following inner symptoms like inability to resist powerful urges to steal items that are not needed. Feeling increased tension, anxiety or arousal leading up to the theft. They feel great pleasure, relief or gratification while stealing but terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft haunt them afterwards.

There is no cure for kleptomania, but treatment with medication or talk therapy (psychotherapy) may help to end the cycle of compulsive stealing. If left untreated, kleptomania can result in severe personal distress, family disharmony and legal consequences.

Given the secrecy and embarrassment that surrounds it, kleptomania often goes undiagnosed. General practitioners/mental health professionals have a unique opportunity to screen for this illness and thus helping prevent the long term consequences that the patient, family or community face.

“Also presence of any another mental illness such as bipolar disorder, anxiety disorder, eating disorder, substance use disorder or a personality disorder may increase the chances for the illness. Low levels of brain chemical called Serotonine which regulates moods and emotions may lead to impulsive behaviors. Addictive disorders caused by stealing may cause the release of dopamine (another neurotransmitter). Dopamine causes pleasurable feelings, and some people seek this rewarding feeling again and again. If someone has imbalance in the brain’s opioid system which regulates the urges could make it harder to resist urges, she added”

According to Dr Isaac Lema, a clinical psychologist based in Dar es Salaam, kleptomania has never been studied separately as a disorder. It therefore is not easy to tell apart ordinary theft from kleptomania.

“Reported cases of kleptomania are very rare and therefore, telling apart the disorder from common thievery is not easy. The underlying factors for stealing vary from place to place and from individual to the other. Causes of kleptomania are not generally understood. It is very hard to separate it from other psychiatric disorder, such as depressive or bipolar disorders, anxiety disorders, eating disorders, personality disorders, substance abuse disorders, and other impulse-control disorders,” he said.

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