Pyromania
What is Pyromania?
Pryomania is the uncontrollable impulse to repeatedly set fires with no obvious motive (such as: concealment of a crime, financial gain, and such).
Official Criteria
The current criteria in DSM IV-TR that must be present in order for the diagnosis to be made include:
- repeated fires that have been deliberately set
- where there is no monetary gain, political expression, criminal concealment, expression of vengance or anger, or impaired judgement (by reason of mental disorder, or other impairment)
- the individual experiences a sense of arousal prior to setting the fire followed by
- a sense of pleasure, relief or gratification when watching or participating in the fire
- the behaviour is not better explained by Antisocial Personality Disorder, a Manic episode or Conduct Disorder.
Prevalence
True pyromania is quite rare and most pyromaniacs are male. There is little good research that focuses on pyromania, as distinct from general fire setting.
Fascination with fire is common among children but this is part of the normal developmental process. Firesetting among children and adolescents is also not uncommon but this is usually associated with Conduct Disorder, ADHD, or Adjustment Disorders.
Manifestation
Individuals with this disorder are fascinated by fire from an early age and experience a sense of gratification, pleasure and arousal from it and this overrides any concern for individual life or property that the fire might cause. Like the other Impulse Control Disorders, individuals with pyromania experience a build-up of tension prior to the event with a release and relief following it.
Co-Morbidity
Mood Disorder and substance abuse problems are commonly found in individuals diagnosed with Pyromania. In addition, many of these inviduals also meet the diagnostic criteria for Intermittent Explosive Disorder.
Treatment
Research has noted low levels of serotonin metabolites in the cerebrospinal fluid of “impulsive arsonists” and the fact that repeat arsonists also have lower levels of these metabolites than non-recidivists . This suggests that serotonin reuptake inhbitors (Prozac-like medications) may be effective in the treatment of pyromania but systematic studies of treatments have rarely been carried out (most reports are of single cases) to provide a definitive anwer.
Further Reading
Mavromatis, M. & Lion, J. (1977). A primer on pyromania. Diseases of the Nervous System, 38, 954-955.
Prins, H. (1994). Fire-raising: Its motivation and management. London: Routledge.
Quinsey, V.l., Chaplin, T. & Upfold, D. (1989). Arsonists and sexual arousal to firesetting; Correlation unsupported. Journal of Behavior Therapy and Experimental Psychiatry, 20, 203-209.
Roy, A., Virkkunen, M., Guthrie, S., & Linnoila, M. (1986). Indices of serotonin and glucose metabolism in violenty offenders, arsonists and alcoholics. Annals of the New York Academy of Sciences, 489, 202-220.
Virkkunen, M.,Dejong, J., Bartko, J. & Linnoila, M. (1989). Psychobiological concomitants of history of suicide attempts among violent offenders and impulsive firesetters. Archives of General Psychiatry, 46, 604-606
Wheaton, S. (2001). Memoirs of a compulsive firesetter. Psychiatric Services, 52, 1035-1036.
Other Resources
A Case of Pryromania. Litman, Larry C. Canadian Psychiatric Bulletin, February 1999. (on-line)
Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders. Martin Kafka, MD, Psychiatric Times (on-line)
© Stephen Hucker, MB,BS, FRCP(C), FRCPsych 2003, 2004,2005
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