Pyromania is an
impulse-control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires,
to relieve some tension or for instant gratification. The term ''pyromania'' comes from the Greek word (''pyr'', 'fire'). Pyromania is distinct from arson, the deliberate setting of fires for personal, monetary or political gain. Pyromaniacs start fires to release anxiety and tension, or for
arousal.
Other impulse-control disorders include
kleptomania
Kleptomania is the inability to resist the urge to steal items, usually for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as an impulse-control disorder. Some of the main ch ...
and
intermittent explosive disorder.
There are specific symptoms that separate pyromaniacs from those who start fires for criminal purposes or due to emotional motivations not specifically related to fire. Someone with this disorder deliberately and purposely sets fires on more than one occasion, and before the act of lighting the fire the person usually experiences tension and an emotional buildup. When around fires, a person with pyromania gains intense interest or fascination and may also experience pleasure, gratification or relief.
Another long term contributor often linked with pyromania is the buildup of
stress. When studying the lifestyle of someone with pyromania, a buildup of stress and emotion is often evident and this is seen in teens' attitudes towards friends and family.
At times it is difficult to distinguish the difference between pyromania and experimentation in childhood because both involve pleasure from the fire.
Classification
ICD
The
World Health Organization
The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
's
International Classification of Diseases
The International Classification of Diseases (ICD) is a globally used medical classification that is used in epidemiology, health management and clinical diagnosis. The ICD is maintained by the World Health Organization (WHO), which is the dir ...
(11th Revision)
ICD-11
The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...
, regarded as the global standard, was released in June 2018 and came into full effect from January 2022.
It states the following about pyromania:
It also notes that pyromania has no relation to
intellectual impairment
Developmental disability is a diverse group of chronic conditions, comprising mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, espe ...
,
substance abuse
Substance misuse, also known as drug misuse or, in older vernacular, substance abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder, differing definition ...
, or other mental and behavioral disorder.
ICD-11 was produced by professionals from 55 countries out of the 90 countries involved and is one of the most widely used reference worldwide by clinicians, with the other being the
Diagnostic and Statistical Manual of Mental Disorders
The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
(
DSM-5-TR
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomy (general), taxonomic and diagnostic tool published by the ...
from 2022,
DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...
from 2013, or their predecessors).
DSM
The
American Psychiatric Association
The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...
's ''Diagnostic and Statistical Manual of Mental Disorders, First Edition'' (
DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...
), released in 1952, categorized pyromania as a subset of
obsessive–compulsive disorder
Obsessive–compulsive disorder (OCD) is a mental disorder in which an individual has intrusive thoughts (an ''obsession'') and feels the need to perform certain routines (''Compulsive behavior, compulsions'') repeatedly to relieve the dis ...
. In the
Second Edition, the disorder was dropped. In the
Third Edition, it returned under the category of impulse-control disorders.
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision'' (
DSM-5-TR
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomy (general), taxonomic and diagnostic tool published by the ...
), released in 2022, states that the essential feature of pyromania is "the presence of multiple episodes of deliberate and purposeful fire setting."
Pyromania moved from the
DSM-IV chapter "Impulse-Control Disorders Not Otherwise Specified," to the chapter "Disruptive, impulse-control, and conduct disorders" in the DSM-5.
Epidemiology
* Pyromania is more prevalent in males than females.
* The average age of pyromania onset is 18.
* Pyromaniacs are often present at fires near them, as well as in nearby fire departments.
* Pyromaniacs may also become firefighters or volunteer to help them.
* It is very rare for pyromaniacs to light fires for sexual gratification. This could be considered Pyrophillia.
Causes
Most studied cases of pyromania occur in children and teenagers. There is a range of causes, but an understanding of the different motives and actions of fire setters can provide a platform for prevention. Common causes of pyromania can be broken down into two main groups: individual and environmental. This includes the complex understanding of factors such as individual temperament, parental psychopathology, and possible neurochemical predispositions.
Many studies have shown that patients with pyromania were in households without a father figure present.
Environmental
Environmental factors that may lead to pyromania include an event that the patient has experienced in the environment they live in. Environmental factors include
neglect from parents and physical or emotional abuse in earlier life. Other causes include early experiences of watching adults or teenagers using fire inappropriately and lighting fires as a stress reliever. Experiences of boredom, or a lack of stimulation within the environment can also be an environmental factor which contributes to acts of pyromania.
Individual
Individual factors contributing to pyromania include emotions and intrinsic drives. One individual factor that could lead to pyromania is feelings of inadequacy, where the individual has the perception that they are not good enough.
This factor is related to the environment in that the perception of inadequacy is derived from environmental events, however when this perception is internalised it becomes an individual factor. Another factor contributing to pyromania is feelings of stress. This could be the buildup of stress over a duration of time or an isolated stressful event.
Patients with pyromania report urges, or intrinsic drives, to set fires.
These fire setting drives can lead to feelings of tension or stress within the individual, and fire setting resolves this tension. Fire setting has also been shown to provide a ‘rush’ of physiological arousal for patients, which produces pleasure. This arousal acts as a positive reinforcer which perpetuates the behaviour and motivates its recurrence.
While not always a cause of the initial fire setting behaviour itself, this tension, and ‘rush’, acts as a cause of pyromania once the initial behaviour has been performed because it drives the same behaviour in the future.
Arson and pyromania
Few arsonists are also classified as pyromaniacs, and while similar, the two are largely not co-morbid.
Arson is often committed to achieve a gain or advantage which has been planned before the act, where the motive is most often revenge or financial, with the intention to cause harm to property, people and infrastructure. Conversely, pyromania is a psychiatric diagnosis,
and it is specified in the DSM-5 that classified pyromaniacs do not set fires for financial advantages or for revenge.
While no gain is planned in advance, planning does still take place for the setting of the fire, such as gathering equipment or flammable items.
Common reasons for misdiagnosis and comorbidity
The prevalence of pyromania is reported to be 3-6% in psychiatric inpatients,
though often undiagnosed in the general adult population.
One reason for this is the shame and secrecy associated with pyromaniac behaviours, which makes individuals reluctant to disclose details about fire setting behaviours to clinicians. It is thought that the secrecy is derived from the fact that intentionally setting fires is a criminal offence,
and fear that clinicians will have to report their behaviour, and the shame is derived from the fact that individuals are not able to control their behaviours, due to the fact that pyromania is an impulse-control disorder.
Another reason for this failure to diagnose is a clinician bias around fire setting. This is because fire setting is often seen simply as a criminal offence leading to underlying motives for the behaviour being ignored.
There is also a lack of training in, and knowledge of, pyromania within clinicians,
as it is a very rare disorder and research on pyromania is scarce.
Pyromania is often misdiagnosed.
This is because fire setting can also be a symptom of other disorders, such as bipolar, substance use and personality disorders.
Bipolar episodes include impulsive behaviours, of which fire setting is one, so pyromania can be misdiagnosed as bipolar disorder if it is assumed that the fire setting is part of a bipolar episode. Substance use disorders and pyromania can occasionally be co-morbid.
In these cases, the two must occur independently: as the DSM-V states, pyromania cannot be diagnosed if the fire setting is a result of substance use.
Treatment and prognosis
The appropriate treatment for pyromania varies with the age of the patient and the seriousness of the condition. For children and adolescents treatment usually is
cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders.
Cognitive behavioral therapy focuses on challenging and chang ...
sessions in which the patient's situation is diagnosed to find out what may have caused this impulsive behavior. Once the situation is diagnosed, repeated therapy sessions usually help continue to a recovery. Other important steps must be taken as well with the interventions and the cause of the impulse behavior. Some other treatments include parenting training, over-correction/satiation/negative practice with corrective consequences, behavior contracting/token reinforcement, special problem-solving skills training, relaxation training, covert sensitization,
fire safety
Fire safety is the set of practices intended to reduce destruction caused by fire. Fire safety measures include those that are intended to prevent wikt:ignition, the ignition of an uncontrolled fire and those that are used to limit the spread a ...
and prevention education, individual and family therapy, and medication.
The prognosis for recovery in adolescents and children with pyromania depends on the environmental or individual factors in play, but is generally positive.
Pyromania is generally harder to treat in adults, often due to lack of cooperation by the patient. Treatment usually consists of more medication to prevent stress or emotional outbursts, in addition to long-term
psychotherapy
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...
. In adults, however, the recovery rate is generally poor, and if an adult does recover, it usually takes a longer period of time. For most adults, their diagnosis of pyromania is chronic, and if fire setting behaviour does go into remission, the behaviour is often substituted for another impulsive behaviour, such as gambling.
Researchers have acknowledged the lack of work on treatment for adult pyromaniacs.
Cognitive-behavioural interventions to reduce the symptoms of pyromania in adults have shown some promise,
especially when focused on improving social skills, relaxation and positive reinforcement of alternative behaviours.
Drug Treatments
Controlled drug treatments for pyromania are fairly limited.
Treatments using
selective serotonin reuptake inhibitors (SSRIs) have been proposed.
SSRIs inhibit the reuptake of serotonin in the brain, meaning the amount of serotonin in the brain is increased through prolonging the duration it stays in the brain before being reabsorbed, and because of this function they are a commonly used antidepressant. As serotonin dysregulation has been implicated in pyromania,
a number of researchers have proposed that SSRIs be used to regulate serotonin levels, and these pharmacological treatments have shown promise.
Other treatments using anti-epileptic medications such as topiramate and sodium valproate, lithium and atypical antipsychotics have also been proposed.
No drug treatments for pyromania have been approved by the Food and Drug Administration.
When considering if a drug treatment might be appropriate, any potential co-morbidities of the individual with pyromania must also be taken into account.
History
Pyromania was thought in the 1800s to be a concept involved with
moral insanity and
moral treatment, but had not been categorized under impulse-control disorders. Pyromania is one of the four recognized types of arson alongside burning for profit, to cover up an act of crime, and for revenge. Pyromania is the second most common type of arson. Common
synonym
A synonym is a word, morpheme, or phrase that means precisely or nearly the same as another word, morpheme, or phrase in a given language. For example, in the English language, the words ''begin'', ''start'', ''commence'', and ''initiate'' are a ...
s for pyromaniacs in colloquial English include firebug (US) and fire raiser (UK), but these also refer to arsonists. Pyromania is a rare disorder with an incidence of less than one percent in most studies; also, pyromaniacs hold a very small proportion of psychiatric hospital admissions. Pyromania can occur in children as young as age three, though such cases are rare. Only a small percentage of children and teenagers arrested for arson are
child pyromaniacs. A preponderance of the individuals are male; one source states that ninety percent of those diagnosed with pyromania are male. Based on a survey of 9,282 Americans using the ''
Diagnostic and Statistical Manual of Mental Disorders
The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
'', 4th edition, impulse-control problems such as gambling, pyromania and compulsive shopping collectively affect 9% of the population. A 1979 study by the
Law Enforcement Assistance Administration found that only 14% of fires were started by pyromaniacs and others with mental illness. A 1951 study by Lewis and Yarnell, one of the largest epidemiological studies conducted, found that 39% of those who had intentionally set fires had been diagnosed with pyromania.
See also
*
Child pyromaniac
*
Firefighter arson
*
Macdonald triad
*
Pyrophobia – the hatred or fear of fire
*
Pyrophilia – arousal or sexual gratification involving fire
References
External links
{{Fire
Fire
Habit and impulse disorders
Mania
Public safety
Impulse-control disorders