done without assistance from, or collaboration with, others.
Associated Features Supporting Diagnosis
Individuals with kleptomania typically attempt to resist the impulse to steal, and they are
aware that the act is wrong and senseless. The individual frequently fears being appre-
hended and often feels depressed or guilty  about the thefts. Neurotransmitter pathways
associated with behavioral addictions, includ ing those associated with  the serotonin, do-
pamine, and opioid systems,  appear to play a role in kleptomania as well.
Prevalence
Kleptomania occurs in about 4%–24% of indivi duals arrested for shoplifting. Its preva-
lence in the general population is very rare, at approximately 0.3%–0.6%. Females outnum-
ber males at a ratio of 3:1.
Development and Course
Age at onset of kleptomania is variable, but th e disorder often begins in adolescence. How-
ever, the disorder may begin in childhood, adolescence, or adulthood, and in rare cases
in late adulthood. There is little systematic information on the course of kleptomania, but
three typical courses have been described: sp oradic with brief episodes and long periods
of remission; episodic with protracted peri ods of stealing and periods of remission; and
chronic with some degree of fluctuation. Th e disorder may continue for years, despite
multiple convictions for shoplifting.