Treatment Options in Kleptomania

Abstract

Kleptomania is a rare disorder with inability or great difficulty in resisting impulses of stealing. People with this disorder are compelled to steal things, generally things of little or no value. This disorder usually begins during puberty and usually last until late adulthood; in some cases lasts throughout the person\'s life. People with this disorder are likely to have a comorbid conditions like mood disorders. Individuals with the disorder are usually referred for treatment due to the comorbid psychiatric complaints rather than kleptomanic behaviour per se. On the other hand literature lacks of studies about the treatment of kleptomania. A wide variety of therapeutic strategies have been proposed for its treatment, among them psychoanalytic oriented psychotherapy, behavioral therapy and pharmacotherapy. Some medications that are used for people diagnosed with kleptomania are selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. There is evidence from numerous case studies that a variety of cognitive behavioral therapy techniques are effective in the treatment of kleptomania and it is favored over other approaches such as psychodynamic and psychoanalytic therapies. Studies to date suggest that cognitive behavioral therapy when used in combination with medication, is more effective than medication alone.

Keywords

• Kleptomania, Impulse Control Disorder, Treatment

Kleptomanide Tedavi Seçenekleri

Öz

Kleptomani temelde çalma dürtülerine karşı koyamamanın yer aldığı az rastlanan bir bozukluktur. Bu bozukluğu olan kişiler genellikle önemsiz veya maddi değeri olmayan nesneleri çalmaya karşı zorlanmaktadırlar. Bu bozukluk genellikle ergenlik döneminde başlar ve geç erişkinliğe kadar sürer, bazı olgularda ömür boyu sürebilir. Kleptomaniye genellikle başka komorbid durumlar örneğin duygudurum bozuklukları gibi bozukluklar eşlik edebilmektedir. Bu bozukluğu olan hastalar çoğunlukla kleptoman için değil ama eşlik eden diğer komorbid durumları nedeni ile tedaviye yönlendirilirler. Diğer yandan kleptomanin tedavisi konusunda yeterice çalışma bulunmamaktadır. Geniş bir spektrumda tedavi stratejileri örneğin psikoanalitik yönelimli psikoterapiler, davranışçı tedaviler ve farmakoterapiler gibi yaklaşımlar önerilmiştir. Kleptomani hastalarının tedavisinde serotonin geri alım inhibitörleri, duygudurum düzenleyiciler ve opioid antagonistleri gibi ilaçlar kullanılmaktadır. Kleptomanide bilişsel davranışçı tedavi yaklaşımlarının etkinliğinin gösterildiği bir çok çalışma bulunmaktadır ve psikodinamik veya psikoanalitik yönelimli psikoterapilerden daha başarılı olduğu gösterilmiştir. Ayrıca bilişsel davranışçı yaklaşımlar eğer ilaç tedavisi ile birlikte kullanılırlarsa sadece ilaç tedavisi yapılan olgulardan daha etkin olmaktadır.

Anahtar Kelimeler

• Kleptomani, Dürtü Kontrol Bozukluğu, Tedavi

Kaynakça

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