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Pyromania
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== Common reasons for misdiagnosis and comorbidity == The prevalence of pyromania is reported to be 3-6% in psychiatric inpatients,<ref name=":1" /> though often undiagnosed in the general adult population.<ref name=":1" /><ref name=":2" /> One reason for this is the shame and secrecy associated with pyromaniac behaviours, which makes individuals reluctant to disclose details about fire setting behaviours to clinicians. It is thought that the secrecy is derived from the fact that intentionally setting fires is a criminal offence,<ref name=":2" /> and fear that clinicians will have to report their behaviour, and the shame is derived from the fact that individuals are not able to control their behaviours, due to the fact that pyromania is an impulse-control disorder.<ref name=":2" /> Another reason for this failure to diagnose is a clinician bias around fire setting. This is because fire setting is often seen simply as a criminal offence leading to underlying motives for the behaviour being ignored.<ref name=":2" /> There is also a lack of training in, and knowledge of, pyromania within clinicians,<ref name=":2" /> as it is a very rare disorder and research on pyromania is scarce.<ref name=":0" /> Pyromania is often misdiagnosed.<ref name=":2" /> This is because fire setting can also be a symptom of other disorders, such as bipolar, substance use and personality disorders.<ref name=":2" /> Bipolar episodes include impulsive behaviours, of which fire setting is one, so pyromania can be misdiagnosed as bipolar disorder if it is assumed that the fire setting is part of a bipolar episode. Substance use disorders and pyromania can occasionally be co-morbid.<ref name=":2" /> In these cases, the two must occur independently: as the DSM-V states, pyromania cannot be diagnosed if the fire setting is a result of substance use.<ref name="dsm" />
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