Pyromania Health Article

Definition

Pyromania is defined as a pattern of deliberate setting of fires for pleasure or satisfaction derived from the relief of tension experienced before the fire-setting. The name of the disorder comes from two Greek words that mean "fire" and "loss of reason" or "madness." The clinician's handbook, the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM, classifies pyromania as a disorder of impulse control, meaning that a person diagnosed with pyromania fails to resist the impulsive desire to set fires—as opposed to the organized planning of an arsonist or terrorist.

The position of the impulse-control disordersas a group within the DSM-IV-TR(DSM,fourth edition, text revised) diagnostic framework, however, has been questioned by some psychiatrists. The differential diagnosisof pyromania and the other five disorders listed under the heading of impulse-control problems (intermittent explosive disorder, kleptomania, pathological gambling, trichotillomania, and impulse-control disorder not otherwise specified) includes antisocial personality disorder(ASPD), mood disorders, conduct disorders (among younger patients), and temporal lobe epilepsy. It is not clear whether the impulse-control disorders derive from the same set of causes as ASPD and mood disorders, or whether "impulse-control disorder" is simply an all-inclusive category for disorders that are otherwise difficult to classify. Some American researchers would prefer to categorize pyromania and the other disorders of impulsivity as a subset of the obsessive-compulsive spectrum.

In addition, the relationship between pyromania in adults and firesetting among children and adolescents is not well defined as of 2002. Although pyromania is considered to be a rare disorder in adults, repeated firesetting at the adolescent level is a growing social and economic problem that poses major risks to the health and safety of other people and the protection of their property. In the United States, fires set by children and adolescents are more likely to result in someone's death than any other type of household disaster. The National Fire Protection Association stated that for 1998, fires set by juveniles caused 6,215 deaths, 30,800 injuries, and $11 billion in property damage. It is significant that some European psychiatrists question the DSM-IV-TRdefinition of pyromania as a disorder of impulse control precisely because of the connection they find between adolescent firesetting and similar behavior in adults. One team of German researchers remarked, "Repeated firesetting, resulting from being fascinated by fire, etc., may be less a disturbance of impulse control but rather the manifestation of a psychoinfantilism, which, supported by alcohol abuse, extends into older age." Pyromania is considered a relatively rare impulse-control disorder in the adult population in North America.