Differential Diagnosis for Stealing Syndrome (Kleptomania)

To approach the differential diagnosis for stealing syndrome, also known as kleptomania, it's essential to consider various psychiatric and neurological conditions that could manifest with similar symptoms. The following categories help organize the differential diagnosis:

• Single Most Likely Diagnosis
  • Kleptomania: This is the most direct diagnosis when considering stealing syndrome. Kleptomania is characterized by recurrent inability to resist urges to steal objects that aren't needed for personal use or for their monetary value. The behavior is often accompanied by feelings of guilt or shame afterward.
• Other Likely Diagnoses
  • Conduct Disorder: Especially in adolescents, conduct disorder can involve deliberate destruction of property, theft, or vandalism, which might be mistaken for kleptomania.
  • Antisocial Personality Disorder: Individuals with this disorder may engage in theft or other illegal activities without remorse, which can be confused with kleptomania.
  • Substance Use Disorders: Certain substances can lower inhibitions and lead to impulsive behaviors, including theft.
  • Bipolar Disorder: During manic episodes, individuals might exhibit impulsive behaviors, including excessive spending or theft.
• Do Not Miss Diagnoses
  • Frontotemporal Dementia: This condition can lead to significant changes in behavior, including impulsivity and poor judgment, which might manifest as stealing.
  • Traumatic Brain Injury: Especially injuries affecting the frontal lobe, can result in impulsivity and poor decision-making.
  • Hypomanic Episodes: Similar to manic episodes but less severe, hypomania can lead to impulsive behaviors.
• Rare Diagnoses
  • Pica: While more commonly associated with eating non-food items, in some cases, pica can involve stealing items to eat or hoard.
  • Factitious Disorder: In some instances, individuals might fabricate or induce illnesses in themselves to gain attention, which could potentially involve stealing for the purpose of creating a false narrative.
  • Neurodevelopmental Disorders: Certain disorders, such as autism spectrum disorder, can sometimes involve repetitive or compulsive behaviors that might be misconstrued as stealing syndrome.

Each of these diagnoses has a unique set of criteria and characteristics. Accurate diagnosis requires a comprehensive evaluation, including psychological assessment, medical history, and sometimes neurological examinations to rule out underlying conditions that could be contributing to the stealing behavior.