Pyromania

Pyromania is a rare psychiatric disorder defined by repeated deliberate fire setting, occurring on more than one occasion. Before lighting fires, individuals with pyromania experience tension or affective arousal, and after the act they feel pleasure, gratification, or relief. The behavior is not motivated by monetary gain, political ideology, revenge, or social or material circumstances, and it cannot be better explained by another mental disorder such as conduct disorder, bipolar mania, or schizophrenia.

According to standard diagnostic criteria, the person is at least six years old, sets fires on multiple occasions, shows a preoccupation with fire or derives pleasure from watching or manipulating flames, and the fire setting causes distress or impairment in social, occupational, or other important areas. The fire setting is not better explained by another disorder (e.g., a manic episode) and is not conducted for illicit gains or to conceal a crime.

Epidemiology and comorbidity information indicate pyromania is very uncommon, with limited precise prevalence data. It is more frequently diagnosed in males and typically emerges in late childhood through adolescence. Pyromania often co-occurs with other psychiatric conditions, such as attention-deficit/hyperactivity disorder, other impulse-control disorders, mood disorders, anxiety disorders, or substance use disorders, complicating assessment and treatment.

Management generally centers on psychotherapy, particularly cognitive-behavioral therapy focused on impulse control, coping skills, and relapse prevention. Family involvement and treatment of comorbid conditions are important components. There is no widely approved specific pharmacotherapy for pyromania; medications may be used to treat co-occurring symptoms or disorders on a case-by-case basis. Fire-safety planning and legal considerations may be relevant in certain cases, alongside ongoing monitoring and support. Prognosis varies, with better outcomes associated with early, integrated treatment and sustained support.