Pyromania DSM-5 312.33 (F63.1)

Pyromania DSM-5 312.33 (F63.1)

DSM-5 Category: Disruptive, Impulse-Control, and Conduct Disorders


Disruptive, impulse-control, and conduct disorders are a class of diagnoses characterized by difficulties controlling emotions and behaviors. These disorders frequently involve uncontrolled impulses leading the individual to violate the rights of others through acts of aggression or destruction, as is the case in pyromania (The American Psychiatric Association, 2013).

Pyromania remains a relatively under-researched and possibly under-reported impulse control disorder. The strong urges to watch existing fires or to set new fires may lead individuals who meet the criteria for pyromania to engage in acts of arson, often endangering their own lives and the lives of others. This is considered a significant risk to the individual with pyromania and those around them (The American Psychiatric Association, 2013).

Symptoms of Pyromania

Pyromania is hallmarked by fascination with and attraction to fire and fire-starting paraphernalia, as well as the deliberate and repeated setting of fires. Individuals diagnosed with pyromania often experience tension or affective arousal before setting a fire, and feelings of pleasure, gratification, or relief during or after fire-starting. Fire setting is not done for monetary or other gain, to conceal crimes, in response to delusion or hallucination, or as a result of a lack of judgment. Additionally, the fire setting behaviors should not be better explained by conduct disorder or other psychiatric illness (The American Psychiatric Association, 2013).

Individuals with pyromania commonly spend time closely associated with fire departments, even becoming firefighters, and are often seen watching any fires in their neighborhoods. It is not uncommon for these individuals to set small fires or set off false alarms in order to see firefighting equipment (The American Psychiatric Association, 2013).

Pyromania is diagnosed significantly more often in males, particularly in those with poor social skills or other learning disabilities, though it is unclear why gender disparity remains so strong (The American Psychiatric Association, 2013).

Diagnosis of Pyromania

Diagnosis of pyromania is typically based on criminal records of repeated or suspicious fire setting and patient reports regarding their emotional relationship with fire. The mechanisms behind pyromania are unclear, and patients often experience episodic remissions in fire-setting urges (The American Psychiatric Association, 2013).

Patients should not be diagnosed with pyromania if their fire setting occurs as a result of conduct disorder, antisocial personality disorder, as a result of hallucinations or other neurological conditions or intellectual disabilities, substance intoxication, or with monetary, revenge, or other malicious intent (The American Psychiatric Association, 2013).

Co-morbidity of Pyromania

Pyromania often occurs alongside a past history of alcohol use disorder, and is most commonly comorbid with antisocial personality disorder, bipolar and depressive disorders, substance use disorder, and pathological gambling. Pyromania very rarely appears as a primary diagnosis (The American Psychiatric Association, 2013).

One study conducted evaluated twenty-one subjects diagnosed with pyromania (ten female, eleven male), and concluded that the mean age of onset was 18 years, with fires set every 5.9 weeks on average. While many of the fires set by individuals in this study did not meet the criteria for arson, they did match the emotional anticipation and release patterns consistent with pyromania. Interestingly, over half (thirteen) of the twenty-one patients were also diagnosed with comorbid Axis I mood disorders, and ten diagnosed with other impulse-control disorders (Gyant & Kim, 2007). As such, further research need to be conducted on pyromania to clarify the possible etiologies and comorbidities associated with the disorder.

Prevalence of Pyromania

The true prevalence of pyromania is currently unknown. Pyromania has been estimated to occur in approximately 1.13% of the population based on population sampling, and has been diagnosed in only 3.3% of individuals incarcerated due to repeated fire setting. Therefore, it is unclear just how many individuals in the general population may meet the criterion for diagnosis with pyromania, while channeling their urges into safe fire-setting techniques (The American Psychiatric Association, 2013).

Currently, over 40% of individuals arrested for arson in the United States are under 8 years of age, indicating that fire-setting in adolescents is a significant concern despite the fact that childhood diagnosis of pyromania remains quite rare. In these cases, it is important to distinguish between the criteria for pyromania and fire-setting behaviors in conduct disorder, attention-deficit/hyperactivity disorder, and other adjustment or impulse control disorders (The American Psychiatric Association, 2013).

Further evaluations of fire scenes by forensic mental health experts, including but not limited to those attributed to arson, may provide more extensive insight into the nature and prevalence of pyromania and breakthroughs in potential treatments (Burton, McNiel, & Binder, 2012). Through careful forensic analysis of fire scenes, experts may be able to provide more accurate data regarding the prevalence of intentional fire setting and techniques use in lighting these fires. This data may be useful when analyzing the tendency for individuals with pyromania to obsess over paraphernalia related to fire, such as lighters.

Treatment of Pyromania

There is a strong indication that individuals diagnosed with impulse-control disorders, including pyromania, may respond well to an approach including the use of psychopharmaceuticals. Selective serotonin reuptake inhibitors (SSRIs), opiate antagonists, mood stabilizers, and atypical use of antipsychotics may contribute to the successful reduction in the symptoms of pyromania (McIntyre, Moral, Serradell, & Prous, 2006).

More recent research indicates that the use of naltrexone, beta blockers, antiandrogens, lithium, and antiepileptics may also be successful in controlling the impulsive symptoms of pyromania. While research into the use of antiepileptics is new and primarily based on case reports, the initial results are promising and should be followed with double-blind clinical trials (Roncero, Rodriguez-Urrutia, Grau-Lopez, & Casas, 2009).

Ultimately, there has not been a significant level of success in controlling the symptoms of pyromania through any one specific treatment. There is a gap in the body of literature related to treatment of impulse disorders, and may make treatment of pyromania difficult (Grant, J.E., Schreiber, L.R.N., & Odiaug, B.L. (2013).

Outcomes for Pyromania

Interest in fire and the presence of antisocial behavior are significantly and positively correlated, with antisocial behavior strongly predictive of recidivism in fire-starting behavior. This indicates that children, adolescents, and adults who demonstrate antisocial behaviors and interest in fire should be monitored and kept in treatment to prevent the urges associated with pyromania from emerging in a dangerous manner (MacKay, et al., 2006).

Due to the potentially dangerous, or even fatal, consequences of pyromania, not to mention the possibility of conviction and incarceration for arson, individuals should remain in lifelong contact with qualified psychiatric personnel.


American Psychiatric Association, The (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Burton, P.R.S., McNiel, D.E., & Binder, R.L. (2012). Firesetting, arson, pyromania, and the forensic mental health expert. Journal of the American Academy of Psychiatry and the Law, 40(3), 355-365.

Grant, J.E., Schreiber, L.R.N., & Odiaug, B.L. (2013). Phenomenology and treatment of behavioural addictions. Canadian Journal of Psychiatry, 58(5), 252-259.

Gyant, J.E., & Kim, S.W. (2007). Clinical characteristics and psychiatric comorbidity of pyromania. Journal of Clinical Psychiatry, 68(11), 1717-1722.

MacKay, S., Henderson, J., Del Bove, G., Marton, P., Warling, D., & Root, C. (2006). Fire interest and antisociality as risk factors in the severity and persistence of juvenile firesetting. Journal of the American Academy of Child and Adolescent Psychiatry, 45(9), 1077-1084.

McIntyre, J., Moral, M.A., Serradell, N., & Prous, J.R. (2006). Psychopharmacology of impulse-control disorders. Drugs of the Future, 31(3), 245-258.

Roncero, C., Rodriguez-Urrutia, A., Grau-Lopez, L., & Casas, M. (2009). Antiepileptic drugs in the control of the impulses disorders. ACTAS Espanolas de Psiquitria, 37(4), 205-212.

Help Us Improve This Article

Did you find an inaccuracy? We work hard to provide accurate and scientifically reliable information. If you have found an error of any kind, please let us know by sending an email to, please reference the article title and the issue you found.

Share Therapedia With Others