Pyromania is an impulse-control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires. An individual with pyromania deliberately 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 or relief. A common cause of pyromania is the buildup of stress in one's life. Pyromania is distinct from arson, which is the deliberate setting of fires for personal, monetary, or political gain. Individuals with pyromania may start fires to release anxiety and tension, or for arousal.
Diagnosis There is a lack of training in, and knowledge of, pyromania among clinicians, as it is a very rare disorder and research on pyromania is scarce. Pyromania is often misdiagnosed, as firesetting can also be a symptom of other disorders, such as bipolar, substance use and personality disorders. Bipolar episodes include impulsive behaviours, so pyromania can be misdiagnosed as bipolar disorder if it is assumed that the firesetting is part of a bipolar episode. Substance use disorders and pyromania can occasionally be comorbid. In these cases, the two must occur independently; the DSM-V states that pyromania cannot be diagnosed if the firesetting is a result of substance use. At times, it is difficult to distinguish the difference between pyromania and experimentation in childhood because both involve receiving gratification from fire. The prevalence of pyromania is reported to be 3–6% in psychiatric inpatients, though it is often undiagnosed in the general adult population. One reason for this is the shame and secrecy associated with firesetting behaviours, which makes individuals reluctant to disclose details 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. The shame is derived from the fact that individuals are not able to control their behaviours, because pyromania is an impulse-control disorder. Another reason for this failure to diagnose is clinician bias around firesetting. Because firesetting is often seen simply as a criminal offence, underlying motives for the behaviour may be ignored.
ICD The ICD-11, the eleventh revision of the World Health Organization's International Classification of Diseases, was released in June 2018 and came into full effect in January 2022. Regarding pyromania, it states:
Pyromania is characterised by a recurrent failure to control strong impulses to set fires, resulting in multiple acts of, or attempts at, setting fire to property or other objects, in the absence of an apparent motive (e.g., monetary gain, revenge, sabotage, political statement, attracting attention or recognition). There is an increasing sense of tension or affective arousal prior to instances of fire setting, persistent fascination or preoccupation with fire and related stimuli (e.g., watching fires, building fires, fascination with firefighting equipment), and a sense of pleasure, excitement, relief or gratification during, and immediately after the act of setting the fire, witnessing its effects, or participating in its aftermath. The ICD-11 also notes that the behavior must not be better explained by intellectual impairment, substance abuse, or other mental and behavioral disorders. The ICD-11 was produced by professionals from 55 countries out of the 90 countries involved and is one of the most widely used references worldwide by clinicians, with the other being the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR from 2022, DSM-5 from 2013, or their predecessors).
DSM The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, First Edition (DSM-I), released in 1952, categorized pyromania as a subset of obsessive–compulsive disorder. In the DSM-II, the disorder was dropped. In the DSM-III, it returned under the category of impulse-control disorders. 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. A 2022 revision of the DSM-5 (DSM-5-TR) states that the essential feature of pyromania is "the presence of multiple episodes of deliberate and purposeful fire setting."
Epidemiology Pyromania is a rare disorder with an incidence of less than one percent in most studies. Pyromaniacs make up 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 have pyromania. 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 DSM-IV, impulse-control problems such as gambling, pyromania, and compulsive shopping collectively affect 9% of the population. Pyromania is more prevalent in males than females. The average age of pyromania onset is 18. Individuals with pyromania often observe fires near them and may spend time at nearby fire departments. Individuals may also become firefighters or volunteer to help them. It is very rare for individuals to light fires for sexual gratification. This could be considered pyrophilia.
Arson and pyromania Few arsonists are also classified as pyromaniacs, and while similar, the two are largely not comorbid. Arson is often committed to achieve a gain that has been planned before the act; 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 advantage or for revenge. While no gain is planned, planning does still take place for the setting of the fire, such as gathering equipment or flammable items.
Causes Most studied cases of pyromania occur in children and adolescents. There is a range of causes; common causes of pyromania can be categorized as environmental or individual. Pyromania may be influenced by factors such as individual temperament, parental psychopathology, and neurochemical predispositions.
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