title: Kleptomania after head trauma: two case reports and combination treatment strategies.
abstract: The purpose of this paper is to add to the growing number of reports about kleptomania occurring in relation to brain injury as well as to present the authors' findings regarding treatment strategies. The authors present two case reports of patients who developed the new onset of kleptomania after closed head trauma. Both patients had comorbid psychiatric symptoms associated with the kleptomania. Antidepressant monotherapy was not beneficial in reducing kleptomania in either patient. Kleptomanic behavior was successfully treated in both patients, however, through combination treatment using an antidepressant agent together with adjunctive cognitive behavioral therapy or adjunctive naltrexone. In one patient, single photon emission tomography showed a perfusion deficit in the left temporal lobe. Various hypotheses regarding this finding and the etiopathology of kleptomania are discussed. Review of current work in the field suggests that kleptomania is a heterogeneous disorder that shares features of both impulse and addiction disorders as well as affective spectrum disorders.
authors.affiliation: The Rehovot Community Mental Health & Rehabilitation Center, Tel Aviv University, Rehovot, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Aizer
authors.forename: Katherine
authors.initials: K
authors.lastname: Lowengrub
authors.forename: Pinhas N
authors.initials: PN
authors.lastname: Dannon
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D006259:Craniocerebral Trauma / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D003511:Cyclohexanols / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D004569:Electroencephalography; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy / Q000523:psychology; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D000069470:Venlafaxine Hydrochloride
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D009292:Narcotic Antagonists; D015283:Citalopram; D009271:Naltrexone; D000069470:Venlafaxine Hydrochloride