Changes in impulse control disorder features in a present kleptomania patient and importance of rational treatment strategy on social dangerousness. a case report

The argument of the present article is the case of a 52 year-old male suffering from compulsive disorders (cocaine addiction, gambling, kleptomania) since adolescence, with behavioural and clinical features changing over time and poorly influenced by pharmacological treatments. At present the patient shows kleptomanic behaviour pharmacologically treated with antipsychotics, antidepressants and anxiolytics. No specific treatment for compulsive spectrum appears to have been effected along the clinical history of the patient. In agreement with international literature, according to which Pathological Gambling, Kleptomania and Substance Abuse share elements of both Obsessive-compulsive Disorder spectrum and affective spectrum disorders, the authors hypothesized for the case a not specific pharmacological treatment which might in time have led an evolution of the disorder symptoms to other forms of Impulse Control Disorders, with severe implications for his social dangerousness. The analysis of the case suggests that a specifically targeted therapy, also included in the general legal system organization, may be effective to contain such an evolution in patients with Impulse Control Disorders. Specific measures are thus needed for the rehabilitation of clinically similar subjects and for the recovery of their mental functions and normal behaviour.