Clinical characteristics and psychiatric comorbidity of pyromania

Background: There have been few systematic studies of individuals with pyromania, and this paucity of research has hindered our understanding and treatment of this disorder. This study details the demographic and phenomenological features of individuals with DSM-IV lifetime pyromania. Method: Twenty-one adult and adolescent subjects (recruited from inpatient and outpatient studies of impulse-control disorders) with lifetime DSM-IV pyromania were administered a semi-structured interview to elicit demographic data and information on the phenomenology, age at onset, and associated features of the disorder. Data were collected from October 2003 to September 2006. Results: Twenty-one subjects (10 female [47.6%]) with lifetime pyromania (mean ± SD age = 26.1 ± 11.8 years; range, 15-49 years) were studied. The mean ± SD age at onset for pyromania was 18.1 ± 5.8 years. Eighteen subjects (85.7%) reported urges to set fires. Subjects reported a mean ± SD frequency of setting 1 fire every 5.9 ± 3.8 weeks. Much of the fire setting did not meet the legal definition of arson. Thirteen (61.9%) had a current comorbid Axis I mood disorder, and 10 (47.6%) met criteria for a current impulse-control disorder. Conclusion: Pyromania appears to be associated with high rates of psychiatric comorbidity. Research is needed to optimize patient care for individuals with this disorder.