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In the last post, we saw how:
- Patients with kleptomania do not steal things they need.
- Patients with conduct disorders find it very hard empthising with others
(Inkscape.org)[Inkscape.org]
Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for four consecutive months. This month will be dedicated to Conduct disorder. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Eating disorders.
In this post, we are looking at Tik Tok. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
In this condition, there are frequent attempts at setting things on fire on purpose and setting things on fire. After settings on fire, the patient feels relieved and unlike the tense way, they would feel before the process. They have an ununderstandable interest in fire, they are closely driven to it.
They go through extensive measures to ensure they can start a fire. They typically do not do it for financial gain or to get back at people who make plans to do so.
There is not enough known about those who are affected by this condition because not many people can be seen as having pyromania. So far this disorder has been seen in more men than women and for every woman with the condition there are eight women affected. Most who set a property on fire and are younger than 18 have pyromania.
Those who suffer from substance abuse disorder, particularly alcohol, are affected by affective disorders, mood disorders and other impulse disorders like kleptomania when they are female.
Attention Deficit and Hypersensitivity Disorder are associated with fire setting in childhood and this can continue even when the child is an adult.
There is also a higher chance of mental retardation than in the regular population. Those who are firesetters may also have some of the features of antisocial personality disorder, for example, they show truant behaviour, stray from home and commit crimes from an early age.
It is a rare finding to have bed wetting in these patients and some studies have not been able to confirm it. There is however animal cruelty seen in many studies of this condition.
The way Freud saw it was that the fire setting had a sexual feeling to it. He saw it as the same warmth that was produced during sexual stimulation and the penis and flame moved similarly.
Other psychoanalysts saw it as a need for power and status. For this reason, some who have pyromania join teams of firefighters to show their might in the face of death, or to inspire others in the face of the fire or to put out the fire.
This is, however, the case for male fire starters females tends to exhibit more sexual behaviour like promiscuity. The female delinquent fire starters do not typically enjoy the sex and they can steal for pleasure or become kleptomaniacs.
When the cerebrospinal fluid of these individuals is examined, they tend to have low levels of 5-HIAA and 3 methoxy-4-hydroxyphenylglycol. This may mean that the abnormality is related to the serotonin pathway or adrenaline pathway.
Some postulate that having low levels of blood glucose is reactive and can be seen as a cause of pyromania however more needs to be done to study these claims.
Risk factors for Conduct Disorder(Reaction)
Image by storyset on Freepik
Demonstrating intervening mechanisms that are reversible, and potentially malleable offers a promising direction in this area. The gap between observational and interventional work is large. Thus far, work in the field, summarized here, suggests that this area holds tremendous promise to help us understand how the urban environment may produce mental health in populations.
Certain factors put a person at risk of conduct disorders and having the features we have described previously like non-adherence to rules and violent behaviour toward people and animals.
Being male is one of them, it has been estimated that males are disproportionally affected by conduct disorders when compared to women. For men, the prevalence in the United States ranges from 6 to 16% while for women it ranges from 2 to 9%. The ratio is somewhere between 4/1 to 12/1.
Another factor that put a person at risk is being an urban settlement. Epigenetic studies on the DNA of those who live in urban settlements show that there is a link between psychopathology and these settlements. Many speculate this to be the reason there some mental health disorders are more common in urban settlements. Conduct disorder just like schizophrenia and others in this list occurs more frequently in urban settings than rural ones.
One risk that shows a biological predisposition to this condition is the fact that those who have this condition have a parent who has other mental health conditions striking this that those who have parents who have antisocial personality disorder are more likely to be affected. Antisocial personality disorder has very similar features and some describe it as the adult variant of conduct disorder.
Compared to the general population those who suffer from alcohol addiction tend to have children with conduct disorder.
One associated risk that is not well understood is the fact that conduct disorders seem to happen commonly in families with low socioeconomic status.
Children who are abused and go through life neglect are also at significant risk of developing this disorder.
Treatment
Just like kleptomania, there is very little known about pyromania and it has been hard over the years to treat this condition especially when these patients do not feel motivated to see themselves get better.
No therapy method has been noted to be effective and for that reason, every attempt must be made like behavioural therapy.
The patient needs close monitoring to ensure that they are not in conditions where they can set fire and it should be noted and added to the treatment modality.
Putting the patient in a maximum security facility helps deal with the frequency of the occurrence of this condition.
It is a very serious problem especially when the firesetter is a child. The child needs to be closely monitored and undergo sessions of cognitive behavioural therapy. They need to be watched carefully to make sure they do not set objects or property on fire. Punishment will not do them any good when they have this disorder and is not encouraged.
Questions
- What did you learn about Conduct disorders?
Conclusion
- Pyromania happens more frequently in men than in women.
- Being male with a poor socioeconomic status and having parents with mental health issues puts you at significant risk of conduct disorders.
- There is no known cure for pyromania.
References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Healthline