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PYROMANIA

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PYROMANIA

The recurrent, deliberate, and purposeful setting of fires.

Associated features

  • Tension or affective arousal before setting the fires.
  • Interest in fire and the actions and tools coupled with firefighting.
  • Gratification, or relief setting fires or witnessing the aftermaths.

Patients make substantial advance arrangements.

Epidemiology

Eight times more frequent in men compared to women

Comorbidity

  • Substance abuse disorders
  • Affective disorders
  • Other impulse control disorders
  • Personality disturbances e.g. borderline personality disorder.
  • Attention-deficit hyperactivity disorder
  • Learning disabilities

History of

  • Enuresis
  • Antisocial acts, such as truancy and delinquency

Aetiology

Psychosocial. 

  • A symbol of sexuality. 
  • Abnormal craving for power and social prestige 
  • Retaliation about the absence of the father
  • Volunteering as a firefighter to vent the frustration
  • Promiscuity and kleptomania in females

Biological Factors. 

  • Low CSF levels of 5-HIAA and 3-methoxy-4-hydroxyphenylglycol (MHPG)
  • Reactive hypoglycemia, based on blood glucose concentrations on glucose tolerance tests

Diagnosis and Clinical Features

Persons with pyromania often regularly watch fires in their neighbourhoods, frequently set off false alarms, and show interest in firefighting paraphernalia. Their curiosity is clear, but they show no remorse and may be indifferent to the consequences for life or property. Firesetters may gain satisfaction from the resulting destruction; frequently, they leave obvious clues. Commonly associated features include alcohol intoxication, sexual dysfunctions, below-average intelligence quotient (IQ), chronic personal frustration, and resentment toward authority figures. Some fire setters become sexually aroused by the fire.

Differential Diagnosis

Arson 

Firesetting for financial gain, revenge, or other motivations, prepared in advance.

Conduct disorder

Studies associate pyromania with a history of antisocial acts, such as truancy and delinquency People with antisocial personality or conduct set fire as an intentional act. They may set fires for profit or retaliation, etc.

Schizophrenia

Patients with schizophrenia or mania may set fires in response to delusions or hallucinations.

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