{{Short description|Irresistance to starting fires}} {{Use dmy dates|date=August 2022}} {{About|the disorder|the album by Def Leppard|Pyromania (album)|other uses}} {{redirect|Pyromaniac|the film|Pyromaniac (film)}} {{Infobox medical condition | name = Pyromania | image = File:Burned container.jpg | caption = Garbage container damaged by fire | pronounce = | field = Psychiatry, clinical psychology | symptoms = Impulsive starting of fires | complications = | onset = | duration = | types = | causes = Parental neglect, early physical or emotional abuse, early observation of inappropriate fire usage | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = | alt = }}
'''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.<ref name="frey">{{Cite book |last=Frey |first=Rebecca J. |chapter=Pyromania |date=2003 |title=Gale Encyclopedia of Mental Disorders |volume=2 |pages=802–806}}</ref> A common cause of pyromania is the buildup of stress in one's life.<ref name="gale1998">{{cite journal|publisher=Gale Research|date=1998|title=Impulse Control Disorders|work=Gale Encyclopedia of Childhood & Adolescence}}</ref>
Pyromania is distinct from arson, which is the deliberate setting of fires for personal, monetary, or political gain.<ref>{{cite book|url=https://books.google.com/books?id=2RzFWRIAsPAC&pg=PA793|title=The American Psychiatric Publishing Textbook of Psychiatry|author=Robert E. Hales|year=2008 |editor1=Stuart C. Yudofsky|editor2=Glen O. Gabbard|publisher=American Psychiatric Pub|isbn=9781585622573|page=793|section=Impulse Disorders Not Elsewhere Classified}}</ref> Individuals with pyromania may start fires to release anxiety and tension, or for arousal.<ref name="WebMD">{{cite web |url=https://www.webmd.com/mental-health/what-is-pyromania |title=What Is Pyromania? |author=<!--Not stated--> |date= 22 June 2021 |website=WebMD.com |publisher= Internet Brands |access-date=28 July 2022 |archive-url=https://web.archive.org/web/20220613025207/https://www.webmd.com/mental-health/what-is-pyromania |archive-date=13 June 2022}}</ref>
==Diagnosis== There is a lack of training in, and knowledge of, pyromania among clinicians,<ref name="Grant-2011" /> as it is a very rare disorder and research on pyromania is scarce.<ref name="Johnson-2017" /> Pyromania is often misdiagnosed, as firesetting can also be a symptom of other disorders, such as bipolar, substance use and personality disorders.<ref name="Grant-2011" /> 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.<ref name="Grant-2011" /> 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.<ref name="dsm" /> At times, it is difficult to distinguish the difference between pyromania and experimentation in childhood because both involve receiving gratification from fire.<ref name="FirstFrances2004">{{cite book|author1=Michael B. First |author2=Allen Frances |author3=Harold Alan Pincus |title=DSM-IV-TR Guidebook |url=https://books.google.com/books?id=hU_L1KUsNfIC&pg=PA337 |access-date=24 February 2013 |year=2004 |publisher=American Psychiatric Pub |isbn=978-1-58562-068-5 |page=337 |url-status=live |archive-url=https://web.archive.org/web/20140925101242/http://books.google.com/books?id=hU_L1KUsNfIC&pg=PA337 |archive-date=25 September 2014 }}</ref>
The prevalence of pyromania is reported to be 3–6% in psychiatric inpatients,<ref name="Burton-2012" /> though it is often undiagnosed in the general adult population.<ref name="Burton-2012" /><ref name="Grant-2011" /> 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<ref name="Grant-2011" /> 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.<ref name="Grant-2011" /> 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.<ref name="Grant-2011" />
===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.<ref name="WHO 2021">{{cite web |url=https://www.who.int/news/item/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11)|title=WHO releases new International Classification of Diseases (ICD 11) |website=World Health Organization |type=Press Release |access-date=29 October 2021}}</ref><ref name="Pickett & Anderson">{{Cite report | vauthors = Pickett D, Anderson RN | title=Status on ICD-11: The WHO Launch | url=https://ncvhs.hhs.gov/wp-content/uploads/2018/08/ICD-11_WHO-v_7-17-2018.pdf | date=18 July 2018 | publisher=CDC/NCHS}}</ref> Regarding pyromania, it states:<ref name=icd11 >{{cite web|url=https://www.findacode.com/icd-11/code-1532500290.html|title=6C70 Pyromania|access-date=13 February 2025}}</ref>
{{Blockquote|text=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.|title=ICD-11|source=chapter 6, section C70}}
The ICD-11 also notes that the behavior must not be better explained by intellectual impairment, substance abuse, or other mental and behavioral disorders.<ref name=icd11 /> 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).<ref name="Pickett & Anderson" />
===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.<ref name="Emergency Live">{{cite web |url=https://www.emergency-live.com/firefighters/pyromania-icd-11-classification-causes-symptoms-characteristics-risks-treatment-medication/ |title=Pyromania: ICD-11 Classification, Causes, Symptoms, Characteristics, Risks, Treatment, Medication |last=Antonino |first=Cristiano |date=4 May 2022 |website=emergency-live.com |publisher=Emergency Live |access-date=30 July 2022}}</ref> 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.<ref name="DSM5 Changes">{{cite web |title=Highlights of Changes from DSM-IV-TR to DSM-5 |url=http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf |date=17 May 2013 |publisher=American Psychiatric Association |archive-date=26 February 2015|archive-url=https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf|url-status=dead}}</ref> 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."<ref name="dsm">{{cite book | last = American Psychiatric Association| author-link = American Psychiatric Association | title = Diagnostic and Statistical Manual of Mental Disorders-V (Text Revision) | volume = 1 | pages = 476–477 |date = May 2013 |publisher = American Psychiatric Publishing, Inc. | location = Arlington, VA, USA | isbn = 978-0-89042-555-8 |title-link = Diagnostic and Statistical Manual of Mental Disorders }}</ref>
== Epidemiology == {{See also|Pyromania in children}}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.<ref>{{cite web|url=https://www.aic.gov.au/publications/bfab/bfab009.html|date=1 March 2005|title=The arsonist's mind: part 2 – pyromania|publisher=Australian Institute of Criminology|url-status=dead|access-date=16 September 2021|archive-date=21 June 2019|archive-url=https://web.archive.org/web/20190621130849/https://aic.gov.au/publications/bfab/bfab009.html}}</ref> Pyromania can occur in children as young as age three, though such cases are rare. Only a small percentage{{Quantify|date=June 2011}} of children and teenagers arrested for arson have pyromania. A preponderance of the individuals are male;<ref>{{cite book|last=Barker|first=A.F.|date=1994|title=Arson: A Review of the Psychiatric Literature|publisher=Oxford University Press}}</ref> one source states that ninety percent of those diagnosed with pyromania are male.{{r|gale1998}} 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.<ref>{{Cite journal |last=Alspach |first=Grif |date=1 August 2005 |title=1 – 2 – 3 – 4... Mental Illness Out the Door? |url=https://aacnjournals.org/ccnonline/article/25/4/8/11651/1-2-3-4-Mental-Illness-Out-the-Door |access-date=2021-09-16 |journal=Critical Care Nurse |volume=25 |issue=4 |pages=8–10 |language=en |doi=10.4037/ccn2005.25.4.8|pmid=16034028 |doi-access=free }}</ref> * Pyromania is more prevalent in males than females.<ref name="Johnson-2017">{{Cite journal |last1=Johnson |first1=R. Scott |last2=Netherton |first2=Elisabeth |date=2017 |title=Fire Setting and the Impulse-Control Disorder of Pyromania |url=https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2016.110707 |journal=American Journal of Psychiatry Residents' Journal |volume=11 |issue=7 |pages=14–16 |doi=10.1176/appi.ajp-rj.2016.110707}}</ref> * The average age of pyromania onset is 18.<ref name="Johnson-2017" /> * Individuals with pyromania often observe fires near them and may spend time at nearby fire departments.<ref name="Johnson-2017" /> * Individuals may also become firefighters or volunteer to help them.<ref name="Johnson-2017" /><ref name="Burton-2012">{{Cite journal |last1=Burton |first1=Paul R S |last2=McNiel |first2=Dale E |last3=Binder |first3=Renée L |title=Firesetting, arson, pyromania, and the forensic mental health expert |journal=Journal of the American Academy of Psychiatry and the Law |date=2012 |volume=40 |issue=3 |pages=355–365 |pmid=22960918 }}</ref> * It is very rare for individuals to light fires for sexual gratification. This could be considered pyrophilia.<ref name="Johnson-2017" />
== Arson and pyromania == Few arsonists are also classified as pyromaniacs, and while similar, the two are largely not comorbid.<ref name="Johnson-2017" /><ref name="Burton-2012" /><ref name="Lindberg-2005">{{Cite journal |last1=Lindberg |first1=Nina |last2=Holi |first2=Matti M |last3=Tani |first3=Pekka |last4=Virkkunen |first4=Matti |date=2005 |title=Looking for pyromania: Characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1993 |journal=BMC Psychiatry |language=en |volume=5 |issue=1 |article-number=47 |doi=10.1186/1471-244X-5-47 |doi-access=free |issn=1471-244X |pmc=1325224 |pmid=16351734}}</ref> 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.<ref>{{Cite journal |last1=Gill |first1=G. |last2=Rothman |first2=S. |last3=Yadav |first3=G. |last4=Riess |first4=P. |date=2022 |title=Arson and Schizophrenia: A Case Report and Review of Literature |journal=European Psychiatry |language=en |volume=65 |issue=S1 |pages=S351 |doi=10.1192/j.eurpsy.2022.891 |issn=0924-9338 |pmc=9562742}}</ref> Conversely, pyromania is a psychiatric diagnosis,<ref name="Grant-2011" /><ref name="Lindberg-2005" /> and it is specified in the DSM-5 that classified pyromaniacs do not set fires for financial advantage or for revenge.<ref name="dsm" /> While no gain is planned, planning does still take place for the setting of the fire, such as gathering equipment or flammable items.<ref name="Burton-2012" />
==Causes== Most studied cases of pyromania occur in children and adolescents.{{r|gale1998}} 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.<ref name="psycnet.apa.org">{{cite journal|title=Pyromania and Firesetting Behaviors |journal=Psychiatric Annals |first=Stephen M |last=Soltys |date=1 February 1992 |volume=22 |issue=2 |pages=79–83 |doi=10.3928/0048-5713-19920201-10 }}</ref>
=== Environmental === Environmental factors include neglect from parents and physical or emotional abuse in early life. Firesetters may have experienced a stressful life event, had early experiences of watching adults use fire inappropriately, or felt peer pressure from those who smoke or play with fire.{{r|frey}} Several studies have found that patients with pyromania were in households without a father figure present.<ref name="google">{{cite book|title=Kaplan & Sadock's Concise Textbook of Clinical Psychiatry|author1=Sadock, B.J.|author2=Sadock, V.A.|date=2008|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|isbn=9780781787468|url=https://books.google.com/books?id=ubG51n2NgfwC|page=365|access-date=27 February 2015}}</ref> Experiences of boredom or a lack of stimulation can also be a contributing factor.<ref name="Johnson-2017" />
=== Individual === Individual factors contributing to pyromania include emotions and intrinsic drive. Feelings of inadequacy, where the individual has the perception that they are not good enough, may lead to firesetting.<ref name="Burton-2012" /> 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 accumulation of stress over a duration of time or an isolated stressful event.<ref name="Burton-2012" /> Patients with pyromania report urges, or intrinsic drives, to set fires.<ref name="Grant-2011" /> These firesetting desires can lead to feelings of tension or stress within the individual, and firesetting resolves this tension. Firesetting has also been found to provide a "rush" of physiological arousal for patients, producing pleasure. While not always a cause of the initial firesetting behaviour, this arousal may act as a positive reinforcement which perpetuates the behaviour and motivates its recurrence.<ref name="Grant-2011">{{Cite book |last1=Grant |first1=Jon E. |title=Oxford Handbook of Impulse Control Disorders |last2=Potenza |first2=Marc N. |date=2011 |publisher=Oxford University Press, USA |isbn=978-0-19-990920-9 |series=Oxford Library of Psychology |location=s.l}}</ref>
==Treatment and prognosis== {{Update section|date=March 2026|reason=Most sources are 10–20 years old}} The appropriate treatment for pyromania varies with the age of the patient and the severity of the condition. For children and adolescents, treatment is usually cognitive behavioural therapy (CBT) sessions in which the practitioner seeks to learn what may cause the impulsive behavior. Once the situation is diagnosed, repeated therapy sessions usually help lead to a recovery.{{r|frey}} Other treatments include parenting training; over-correction, satiation, or negative practice with corrective consequences; behavioural contracting or token reinforcement; special problem-solving skills training; relaxation training; covert sensitization; fire safety and prevention education, individual and family therapy; and medication.<ref name="psycnet.apa.org" /> The prognosis for recovery in adolescents and children with pyromania depends on the environmental or individual factors, but is generally positive.{{Citation needed|date=March 2026}}
Pyromania is generally harder to treat in adults "because of the lack of insight and cooperation on the part of most patients diagnosed with the disorder".{{r|frey}} Treatment usually consists of medication to prevent stress or emotional outbursts,<!--Oliver?--> in addition to long-term psychotherapy.{{r|frey}} In adults, the recovery rate is generally poor; if an adult does recover, it usually takes a longer period of time.{{r|frey}} For most adults, their diagnosis of pyromania is chronic, and if firesetting behaviour does go into remission, the behaviour is often substituted for another impulsive behaviour, such as gambling.<ref name="Burton-2012" />
Researchers have acknowledged the lack of work on treatment for adult pyromaniacs.<ref name="Johnson-2017" /><ref name="Opdyke-1998">{{Citation |last1=Opdyke |first1=Dan |title=14 - Cognitive-Behavioral Treatment of Impulse Control Disorders |date=1998-01-01 |work=International Handbook of Cognitive and Behavioural Treatments for Psychological Disorders |pages=417–439 |editor-last=Caballo |editor-first=V. E. |url=https://linkinghub.elsevier.com/retrieve/pii/B978008043433950016X |access-date=2025-05-03 |place=Oxford |publisher=Elsevier Science Ltd |doi=10.1016/b978-008043433-9/50016-x |isbn=978-0-08-043433-9 |last2=Rothbaum |first2=Barbara Olasov|url-access=subscription }}</ref> Cognitive-behavioural interventions to reduce the symptoms of pyromania in adults have shown some potential,<ref name="Burton-2012" /><ref name="Opdyke-1998" /> especially when focused on improving social skills, relaxation, and positive reinforcement of alternative behaviours.<ref name="Opdyke-1998" />
=== Drug treatments === Controlled drug treatments for pyromania are fairly limited.<ref name="Burton-2012" /> Treatments using selective serotonin reuptake inhibitors (SSRIs) have been proposed.<ref name="Johnson-2017" /><ref name="Burton-2012" /> As serotonin dysregulation has been implicated in pyromania,<ref name="Grant-2011" /> a number of researchers have proposed that SSRIs be used to regulate serotonin levels; these pharmacological treatments have shown potential.<ref name="Johnson-2017" /><ref name="Burton-2012" /><ref name="Grant-2011" /> Researchers have also proposed treatments using lithium, atypical antipsychotics, and anti-epileptic medications such as topiramate and sodium valproate.<ref name="Johnson-2017" /><ref name="Burton-2012" /><ref name="Grant-2011" /> No drug treatments for pyromania have been approved by the Food and Drug Administration of the United States.<ref name="Grant-2011" /> When considering if a drug treatment might be appropriate, any potential comorbidities of the individual with pyromania must also be taken into account.<ref name="Johnson-2017" />
==History== The term ''pyromania'' comes from the Greek word {{lang|grc|πῦρ}} (''pyr'', 'fire'). In the 1800s, pyromania was thought to be a concept involved with moral insanity and moral treatment, but it had not been categorized under impulse-control disorders.{{Citation needed|date=March 2026}} In 1967, pyromania was categorized as the second-most common of four types of arson, alongside burning for profit, to cover up a criminal act, and for revenge.<ref>{{cite journal|url=http://psycnet.apa.org/psycinfo/1967-12122-001 |title=ARSON: WITH SPECIAL REFERENCE TO PYROMANIA. |date=1 January 1967 |url-status=live |archive-url=https://web.archive.org/web/20150509015320/http://psycnet.apa.org/psycinfo/1967-12122-001 |archive-date=9 May 2015 }}</ref> A 1951 study by Lewis and Yarnell, one of the largest epidemiological studies of pyromania, found that 39% of those who had intentionally set fires had been diagnosed with pyromania. These high rates of prevalence were not confirmed by later research.<ref>{{cite book|first=Robert E.|last=Hales|title=The American Psychiatric Publishing Textbook of Psychiatry|date=2008|publisher=American Psychiatric Pub |isbn=9781585622573|url=https://books.google.com/books?id=2RzFWRIAsPAC&pg=PA791}}</ref> A 1979 study by the Law Enforcement Assistance Administration found that only 14% of fires were started by pyromaniacs and others with mental illness.<ref>{{cite journal|title=The Risk of Fire – Statistical Data Included|date=1 October 1999|journal=Risk & Insurance|first=Thomas E.|last=Smith}}</ref>
==See also== * Firefighter arson * Macdonald triad * Pyrophobia – the hatred or fear of fire
==References== {{Reflist}}
== External links == {{sister project links||d=Q622604|c=Category:Pyromania|n=no|q=no|b=no|v=no|voy=no|m=no|mw=no|s=no|wikt=pyromania|species=no}}
{{Medical resources | DiseasesDB = | ICD10 = {{ICD10|F|63|1|f|60}} | ICD9 = {{ICD9|312.33}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D005391 |ICD11={{ICD11|6C70}}}} {{Fire}} Category:Fire Category:Habit and impulse disorders Category:Mania Category:Public safety Category:Impulse-control disorders