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Published online by Cambridge University Press: 16 April 2020
The objective of the study was to examine phenomenology and comorbidity of repeated stealing behavior in a group of 72 adult male forensic psychiatric patients. 38 have diagnosis of dissocial personality disorder and 34 – kleptomania by clinical-psychopathological method (structured and semistructured clinical interview) and non-parametric statistical analysis.
The comorbid disorders for antisocial disorder were organic disorders mostly of perinatal origin and ADHD syndrome in childhood. For kleptomania there were non-psychotic affective states and personality disorders: schizoid, schizotypal, borderline and emotionally unstable of borderline type. The repeated theft in both groups served as habitual tool for emotional self-regulation since all the patients had dysthimic or dysphoric mood swings and unstable self-esteem. Their repeated criminal pattern responded to criteria of dependence syndrome listed in ICD-10 for substance abuse. We described them in terms of feeling of psychological dependence, distorted physical and psychological reactivity, and personality scarcity at the final stage of dependence when stealing behavior became serial, clichéd and followed by symbolic rituals. In antisocial personality disorder we observed tends to switching to more hetero-destructive behavior - pyromania, zoocides and sexual sadism served as substitution first and then developing the traits of addiction. In kleptomania auto-destructive kinds were more common (habitual self-mutilation, alcohol and drug dependence, exhibitionism, pedophilia, sadomasochism). Forensic psychiatric evaluation included assessment the urge to steal (impulsive, compulsive or obsessive) and degree of emotional disturbances as well as comorbid disorders (both underlying and substituting) to estimate the quality of volitional control.
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