Looking for pyromania: characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1993.
BACKGROUND
As pyromania is a rare diagnosis with questionable validity, we aimed to describe a forensic psychiatric population of arson recidivists.


METHODS
The medical records as well as the forensic psychiatric examination statements of 90 arson recidivists referred for pretrial psychiatric assessment in Helsinki University Hospital Department of Forensic Psychiatry between 1973 and 1993 were reviewed.


RESULTS
The most important diagnostic categories of arson recidivists were personality disorders, psychosis and mental retardation, often with comorbid alcoholism. In all, 68% of arsonists were under alcohol intoxication during the index crime. Psychotic as well as mentally retarded persons with repeated fire-setting behaviour were mostly "pure arsonists"--persons guilty only of arsons during their criminal careers. Arson recidivists with personality disorder, in contrast, often exhibited various types of criminal behaviour and arson appeared to be only one expression of a wide range of criminal activity. Comorbid alcoholism was apparently a more rarely observed phenomenon among pure arsonists than in "nonpure arsonists". We found only three subjects fulfilling the present diagnostic criteria for pyromania.


CONCLUSIONS
Using the criteria of the DSM-IV-TR, pyromania must be regarded as an extremely rare phenomenon. Especially the question of substance intoxication as an exclusion criterion for pyromania should be reconsidered.
Lindberg
Nina
N
Department of Psychiatry, University of Helsinki, Finland. nina.lindberg@hus.fi
Holi
Matti M
MM
Tani
Pekka
P
Virkkunen
Matti
M
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003417:Criminal Psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005387:Finland / Q000453:epidemiology; D005391:Firesetting Behavior / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005555:Forensic Psychiatry / Q000706:statistics & numerical data; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000453:epidemiology; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology; D012008:Recurrence; D012737:Sex Factors