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Psychopathology and Comorbidity of

Psychopathology and Comorbidity of Psychiatric
Disorders in Patients With Kleptomania
Franck J. Baylé, M.D.
Hervé Caci, M.D., Ph.D.
Bruno Millet, M.D., Ph.D.
Sami Richa, M.D.
Jean-Pierre Olié, M.D.
Objective: This study compared patients
with kleptomania, patients with alcohol
abuse or dependence, and psychiatric patients
without impulse-control disorders or
substance-related disorders on several key
psychopathological dimensions. In addition,
the comorbidity of kleptomania with
other psychiatric disorders was examined.
Method: Eleven patients with kleptomania
recruited over a cumulative 2-year period
and 60 patients with alcohol abuse or
dependence and 29 psychiatric comparison
patients recruited over a consecutive
6-month period participated in structured
clinical interviews to determine the presence
of impulse-control and substancerelated
disorders and of other psychiatric
disorders that were comorbid with kleptomania.
Psychopathological dimensions
were measured with the Barratt Impulsiveness
Scale, the Sensation Seeking Scale, the
Montgomery-Åsberg Depression Rating
Scale, and the anxiety and depression subscales
of the Hospital Anxiety and Depression
Scale.
Results: Significant group effects were
found for the Barratt Impulsiveness Scale
total and cognitive impulsivity scores, with
the patients with kleptomania having
higher impulsivity scores than the other
groups. Significant group differences were
found on the Sensation Seeking Scale total
and disinhibition scores. No significant
group effects were found for the mood
and anxiety measures. Patients with kleptomania
had high rates of comorbid psychiatric
disorders, particularly mood disorders,
other impulse-control disorders, and
substance abuse or dependence (mainly
nicotine dependence).
Conclusions: Kleptomania presented a
specific psychopathological profile that
distinguished patients with this disorder
from patients with alcohol abuse or dependence
and other psychiatric comparison
patients. Impulsivity was the major
psychopathological feature of kleptomania.
A link between kleptomania and affective
disorder was supported by the high
rate of comorbid affective disorders in patients
with kleptomania and a specific pattern
of variation in the two conditions over
time. Further prospective studies are
needed to confirm this pattern. Because
kleptomania is characterized by a low rate
of comorbid substance-related disorders
other than nicotine dependence and by
severe psychopathology, it could be an appropriate
disorder in which to study the information
processes and psychobiology
underlying impulsivity.
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Psychopathology and Comorbidity of PsychiatricDisorders in Patients With KleptomaniaFranck J. Baylé, M.D.Hervé Caci, M.D., Ph.D.Bruno Millet, M.D., Ph.D.Sami Richa, M.D.Jean-Pierre Olié, M.D.Objective: This study compared patientswith kleptomania, patients with alcoholabuse or dependence, and psychiatric patientswithout impulse-control disorders orsubstance-related disorders on several keypsychopathological dimensions. In addition,the comorbidity of kleptomania withother psychiatric disorders was examined.Method: Eleven patients with kleptomaniarecruited over a cumulative 2-year periodand 60 patients with alcohol abuse ordependence and 29 psychiatric comparisonpatients recruited over a consecutive6-month period participated in structuredclinical interviews to determine the presenceof impulse-control and substancerelateddisorders and of other psychiatricdisorders that were comorbid with kleptomania.Psychopathological dimensionswere measured with the Barratt ImpulsivenessScale, the Sensation Seeking Scale, theMontgomery-Åsberg Depression RatingScale, and the anxiety and depression subscalesof the Hospital Anxiety and DepressionScale.Results: Significant group effects werefound for the Barratt Impulsiveness Scaletotal and cognitive impulsivity scores, withthe patients with kleptomania havinghigher impulsivity scores than the othergroups. Significant group differences werefound on the Sensation Seeking Scale totaland disinhibition scores. No significant
group effects were found for the mood
and anxiety measures. Patients with kleptomania
had high rates of comorbid psychiatric
disorders, particularly mood disorders,
other impulse-control disorders, and
substance abuse or dependence (mainly
nicotine dependence).
Conclusions: Kleptomania presented a
specific psychopathological profile that
distinguished patients with this disorder
from patients with alcohol abuse or dependence
and other psychiatric comparison
patients. Impulsivity was the major
psychopathological feature of kleptomania.
A link between kleptomania and affective
disorder was supported by the high
rate of comorbid affective disorders in patients
with kleptomania and a specific pattern
of variation in the two conditions over
time. Further prospective studies are
needed to confirm this pattern. Because
kleptomania is characterized by a low rate
of comorbid substance-related disorders
other than nicotine dependence and by
severe psychopathology, it could be an appropriate
disorder in which to study the information
processes and psychobiology
underlying impulsivity.
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Psikopatologi dan Komorbiditas dari Psychiatric
Gangguan pada Pasien Dengan kleptomania
Franck J. Bayle, MD
Hervé Caci, MD, Ph.D.
Bruno Millet, MD, Ph.D.
Sami Richa, MD
Jean-Pierre Olie, MD
pasien studi ini dibandingkan: Tujuan
dengan kleptomania, pasien dengan alkohol
penyalahgunaan atau ketergantungan, dan pasien kejiwaan
tanpa gangguan impuls-kontrol atau
gangguan-zat yang terkait pada beberapa kunci
dimensi psikopatologis. Selain itu,
para komorbiditas kleptomania dengan
gangguan kejiwaan lainnya diperiksa.
Metode: pasien Eleven dengan kleptomania
direkrut selama periode 2 tahun kumulatif
dan 60 pasien dengan penyalahgunaan alkohol atau
ketergantungan dan 29 perbandingan kejiwaan
pasien direkrut selama berturut-turut
periode 6 bulan berpartisipasi di terstruktur
wawancara klinis untuk menentukan adanya
impuls-kontrol dan substancerelated
gangguan dan kejiwaan lainnya
gangguan yang komorbiditas dengan kleptomania.
dimensi psikopatologis
diukur dengan Barratt Impulsif
Skala, Sensasi Mencari Skala, yang
Montgomery-Åsberg Depresi Penilaian
Skala, dan kecemasan dan depresi subskala
dari Kecemasan Rumah Sakit dan Depresi
Skala.
Hasil: efek kelompok yang signifikan
ditemukan Barratt Impulsif Skala
total dan skor impulsif kognitif, dengan
pasien dengan kleptomania memiliki
skor impulsif lebih tinggi dari yang lain
kelompok. Perbedaan kelompok yang signifikan
ditemukan pada Sensation Seeking jumlah Skala
dan rasa malu skor. Tidak ada yang signifikan
efek kelompok yang ditemukan untuk mood
tindakan dan kecemasan. Pasien dengan kleptomania
memiliki tingkat tinggi komorbiditas psikiatrik
gangguan, terutama gangguan mood,
gangguan impuls-kontrol lainnya, dan
penyalahgunaan zat atau ketergantungan (terutama
ketergantungan nikotin).
Kesimpulan: kleptomania disajikan
profil psikopatologis tertentu yang
dibedakan pasien dengan gangguan ini
dari pasien dengan alkohol penyalahgunaan atau ketergantungan
dan perbandingan kejiwaan lainnya
pasien. Impulsif adalah besar
fitur psikopatologis dari kleptomania.
Sebuah hubungan antara kleptomania dan afektif
gangguan didukung oleh tingginya
tingkat gangguan afektif komorbiditas pada pasien
dengan kleptomania dan pola tertentu
dari variasi dalam dua kondisi di atas
waktu. Prospektif studi lebih lanjut
diperlukan untuk mengkonfirmasi pola ini. Karena
kleptomania ditandai dengan tingkat rendah
dari gangguan-zat terkait komorbiditas
selain ketergantungan nikotin dan dengan
psikopatologi berat, itu bisa menjadi tepat
gangguan di mana untuk mempelajari informasi
proses dan psychobiology
impulsif yang mendasari.
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