https://www.tiktok.com/@urfavbipolarbitch.gov/video/7122563098271026474?is_from_webapp=1&sender_device=pc&web_id=7146615854787839493
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In the last post, we saw how:
- Pyromania happens more frequently in men than in women.
- Being male with a poor socioeconomic status and having parents with mental health issues puts you at significant risk of conduct disorders.
- There is no known cure for pyromania.
(Inkscape.org)[Inkscape.org]
Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for four consecutive months. This month will be dedicated to Conduct disorder. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Eating disorders.
In this post, we are looking at Tik Tok. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
Those who have this disorder tend to regularly look at fires anywhere they find the opportunity and will not hesitate to start one. They typically have more interest in firefighting than the typical person.
It is usually very easy to see that these people are more interested in the fire so much so that they will not care about the effect it might have on people’s life or if it might kill. They in fact have will show just how satisfying the destruction can have on people and they show it evidently.
They have frequent episodes of alcohol abuse and drunkenness. They frequently have sexual dysfunction. Their IQ is usually below average and does not like symbols of authority.
It is also possible for someone with pyromania to find fire sexually stimulating.
It is easy to differentiate a child’s curiosity for fire and the feelings a person with pyromania has for fire. Children do it in a manner that follows their attempts at trying to understand their environment.
It is also very important for a fire that was set by a political movement or those who had been paid to carry out some of these actions, these arsonists should be handled by the court system.
There might be those who set the thing on fire because they suffer from conduct disorder and antisocial personality disorder the distinction is that they do it on purpose and not because of an impulse to do so.
People may set the fire because of vengeance or to destroy someone else property so trying to find out why the perpetrator did it is very important.
Those in a manic state who are in a state of delusion or are hallucinating like in schizophrenia or mania may set fire in response to these symptoms.
Those who have degenerative brain conditions such as dementia may set things on fire. Those abused substances may also set things on fire.
Even though pyromania can start in childhood, nobody is exactly sure of when this condition starts. When it takes place in adolescence or in adult life the patient should be watched for intent and it might not be a case of pyromania.
Pyromania usually occurs in episodes and it may come and go.
This condition usually has the best outcome when it happens in childhood. When it takes place in adult life, it is usually hard to tell because they do not usually own up to the fire setting.
Differential Diagnosis of Conduct Disorder(Reaction)
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One of the main differentials for a child with the behaviour seen in conduct disorder is oppositional defiant disorder. The clinical features seen in this disorder include arguing, not following orders and being pessimistic.
These are features that are very similar to those in conduct disorder but the main difference is that those with the oppositional defiant disorder are not violent even though they always disagree with authority. Those who have conduct disorder tend to have more interactions with law enforcement.
The psychiatric disorders seen in the parents of those with conduct disorder are mostly antisocial personality disorders. It is also possible for those who have the oppositional defiant disorder to develop the features of conduct disorder.
Children and adolescents with major depression or dysthymia may be defiant in their behaviour especially when they project the cause of their problems onto their parents. This might be the case for other mood disorders also as is seen in bipolar disorder. When the patient has a manic episode they may exhibit some defiant behaviour.
There is also the case that mood disorders and conduct disorders tend to overlap with depressive features.
Substance abuse is also another differential for conduct disorder as substance abuse is seen in conduct disorder. The main difference is that conduct disorder has clear cases of experimentation as opposed to what is seen in substance abuse. Those who abuse substances are not able to control themselves and so they may be impulsive.
In intermittent explosive disorder, there are impulsive episodes of violence without any trigger and the only way to diagnose this condition is to compare its features with those of conduct disorder. Those who have intermittent explosive disorder never have the thought beforehand to behave violently and they only got triggered and behaved that way.
In children, intermittent explosive disorder is seen as a problem with the patient's behaviour and they do not show any other feature of innate aggressiveness.
Treating Pyromania
If nothing is done about pyromania it can become worse as time goes by it is also possible in very rare cases for it to go away but it is best to seek help from trained professionals. If it is handled properly it can do into remission but it will require sufficient motivation on the part of the patient.
The treatment for this condition is never straightforward forward and it requires important treatment methods like psychotherapy and drug therapy. The viable option for treatment includes cognitive behavioural therapy that involves behavioural modifications and new ways of coping with difficult situations.
The drugs used to treat this condition include those for depression like Selective Serotonin Reuptake Inhibitors or SSRIs. Drugs for anxiety have also been used to treat this condition.
Antiepileptic drugs (drugs used to treat epilepsy), antipsychotics (drugs used in schizophrenia), mood stabilizers such as lithium, and drugs used to stop the action of androgen such as testosterone have all been helpful in managing this condition.
Those who have this disorder may have issues with understanding their triggers and how to deal with them. They may have problems with what to do when they see fire or think about it and they usually find help in cognitive behavioural therapy. The doctor may devise special means through which those who suffer from this condition can deal with it properly.
If the case is that a child is the one with the tendency to set things on fire or is diagnosed it will be helpful to involve the child's parents in therapy so that they can learn to keep the house fireproof and away from triggers as the child learns to cope.
Questions
- What did you learn about Conduct disorders?
Conclusion
- Children have a better prognosis than adults in firesetting.
- Differentials for conduct disorder may be Oppositional defiant disorder, antisocial personality disorder, schizophrenia or mood disorders.
- Treatment for pyromania is both CBT and pharmacotherapy.
References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Healthline