Pyromania: ICD-11 classification, causes, symptoms, characteristics, risks, treatment, medication
Pyromania (or “pathological fire-starting”) is a behavioural addiction characterised by an intense obsession with fire, the tools that generate it (such as explosives), the tools related to it (e.g. fire-fighting devices) and the effects it generates
In many cases, the arsonist deliberately sets fires that can be dangerous and cause damage to people and/or property: in this case, the arsonist is forced to suffer the criminal consequences of his actions, which can also lead to deprivation of liberty.
The term ‘pyromania’ derives from the Greek πῦρ (pronounced ‘pur’, fire) and μανία (pronounced ‘mania’, obsession)
Epidemiology
Pyromania is the second most common type of arson.
Pyromania is a rare disorder with an incidence of less than 1% in most studies; moreover, pyromaniacs account for a very small proportion of admissions to psychiatric hospitals.
Pyromania can occur in children as young as three years old, although such cases are rare.
Only a small percentage of children and adolescents arrested for arson are child arsonists.
A preponderance of the individuals are male; 90% of those diagnosed with pyromania are male.
A 1979 study by the Law Enforcement Assistance Administration found that only 14% of fires were set by arsonists and others with mental illness.
A 1951 study by Lewis and Yarnell, one of the largest epidemiological studies conducted, found that 39% of those who intentionally set fires were diagnosed with pyromania.
ICD-10 Classification of Pyromania
Pyromania is placed in class F63 in the ICD 10 classification (the 10th International Classification of Diseases, Accidents and Causes of Death; ICD stands for International Statistical Classification of Diseases).
Pyromania is referred to as ‘F63.1 – Pathological attraction to arson’ and described as ‘A disturbance characterised by numerous acts of arson of property or other objects or attempts at arson, which are committed without any obvious motivation, and an enthusiasm for everything related to fire and combustion.
This behaviour is often associated with an increasing feeling of tension before the action and a strong excitement immediately afterwards’.
The classification excludes pyromania:
- in an adult with dissocial personality disorder (F60.2)
- as an excuse for monitoring a person with suspected mental disorder (Z03.2)
- with alcohol or psychoactive substance intoxication (F10-F19)
- in behaviour disorders (F91)
- in organic mental disorders (F00-F09)
- in schizophrenia (F20).
ICD-11 classification of Pyromania
In the most recent ICD-11, which officially came into force on 1 January 2022, pyromania is referred to by code ‘6C70’ and defined as follows:
“Pyromania is characterised by a recurrent inability to control strong impulses to set fires, resulting in multiple acts or attempts to set fire to property or other objects, in the absence of an apparent motive (e.g. monetary gain, revenge, sabotage, political motives, attracting attention or recognition).
There is an increasing sense of tension or affective arousal before lighting the fire, persistent fascination or preoccupation with fire and related stimuli (e.g., watching fires, setting fires, attraction to firefighting equipment), and a sense of pleasure, excitement, relief, or gratification during and immediately after the act of setting fire, witnessing its effects, or participating in its consequences.
The behaviour is not best explained by intellectual impairment, another mental and behavioural disorder, or substance intoxication”.
The classification excludes pyromania:
- in an adult with dissocial personality disorder (6C91)
- as an excuse for monitoring a person with suspected mental disorder (QA02.3)
- bipolar disorder type I (6A60)
- in schizophrenia or other primary psychotic disorder (6A20-6A2Z)
Why do pyromaniacs set fires? The causes of pyromania
Little is known about the causes of pyromania.
The probable causes of pyromania can be divided into two main groups: individual and environmental.
Individual causes
Possible individual factors that could cause or promote pyromania include:
- individual temperament;
- familiarity with pyromania (siblings or parents with pyromania);
- possible neurochemical and genetic predispositions;
- particular neurological conditions such as frontal syndrome;
- psychiatric illnesses;
- other behavioural addictions;
- addictions to legal and/or illegal substances.
Some medical research has concluded that there may be a link with hypoglycaemia or a decreased concentration of 3-methoxy-4-hydroxophenylglycolic acid and 5-hydroxyindoleacetic acid in the spinal fluid.
Similarities have also been found in sick individuals, such as abnormalities in the levels of neurotransmitters like norepinephrine and serotonin, which could be linked to impulse control problems, as well as reduced blood sugar levels.
Environmental causes
Environmental factors that could lead to pyromania include:
- parental psychopathology;
- absence of a father figure;
- abandonment by both parents;
- physical, sexual or other trauma or abuse suffered at an early age;
- early experiences of observing adults or adolescents using fire inappropriately and/or lighting fires as entertainment or stress relief;
- poor social skills;
- unrewarding sexuality;
- accumulation of psycho-physical stress;
- the perception of having some kind of deficiency (shortness of stature, feeling ugly, feeling unappreciated by others, thinking they have small genitals…).
Children who suffer from this disorder often have a history of cruelty to animals.
They may also frequently suffer from other behavioural disorders and have attention and learning disorders.
Symptoms and characteristics of pyromania
The arsonist cannot control the impulse to deliberately light fires.
Lighting a fire allows the arsonist to feel euphoria and relieve tension.
Before the act of lighting a fire the person usually experiences tension and emotional build-up.
When around fires, a person suffering from pyromania acquires an intense interest or fascination and may also experience pleasure, gratification or relief.
If the fire is not lit, the pyromaniac feels increasing anxiety similar to withdrawal symptoms.
In the ‘real’ arsonist the deliberate lighting of fires is NOT done for personal, monetary, political or other gain, e.g. for revenge or to cover up another crime.
The arsonist acts for personal satisfaction, without any other motivation: in some cases it is just the pleasure of seeing what their actions cause in other people, or of observing the behaviour needed to extinguish the fires they start; there is also sometimes the pleasure of reading about their actions in newspapers or hearing about their effects in the media.
Some arsonists state that their pleasure in this action lies only in lighting the fire for the sake of it, in watching the darting flames: others feel relieved of tension as they watch the objects melt, burn, and the whole thing is self-sustaining.
Pyromaniacs often fixate on fire-related objects in general (explosives, fire extinguishers…) and on fire control institutions such as fire stations and fire brigades.
Pyromania is frequently associated with other conditions in which impulse control is impaired, in particular behavioural addictions (pathological gambling, sex addiction, kleptomania, compulsive shopping), legal substance addictions (alcoholism, drug addiction, smoking…) and illegal substance addictions (cocaine, heroin…).
The arsonist often suffers from attention and learning disorders. In some cases, the arsonist suffers from depression and has attempted suicide, e.g. by slitting his wrists.
Arsonists often behave in a way that ranges from sadness and loneliness to anger.
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Risks
One of the most dangerous risks associated with pyromania is that of causing damage to property and/or living beings, in some cases even setting fire to houses, animals and/or people.
The risk is therefore that of a criminal charge, even a serious one (e.g. manslaughter, involuntary manslaughter or voluntary manslaughter), which can lead to house arrest or prison.
Another risk for the arsonist is that of injuring oneself, e.g. by being burnt, or of losing property because one has set fire to it (e.g. one’s car or house).
Diagnosis
The diagnosis is mainly based on the description of the subject’s behaviour and the characteristics listed in the section “Symptoms and characteristics”, excluding the cases listed in the section “ICD-11 classification”.
Treatment
The appropriate treatment for pyromania varies with the age of the patient and the severity of the condition.
For children and adolescents, treatment usually consists of cognitive-behavioural psychotherapy sessions.
Other treatments include parenting training, family therapy, support groups, narrative medicine strategies, and narrative exposure therapy.
In adults, in addition to cognitive-behavioural therapy, drugs such as SSRIs (selective serotonin reuptake inhibitors) can also be combined.
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Prognosis for pyromania
The prognosis for recovery in adolescents and children suffering from pyromania depends on the environmental or individual factors involved, but is generally positive.
Pyromania is generally more difficult to treat in adults, often due to a lack of cooperation from the patient.
In adults, however, the cure rate is generally poor and recurrences are more frequent, which is why it is important to intervene early when the person is still young and has a better prognosis.
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