Psych · Forensic psychiatry — arson and firesetting
Arson and fire-setting
Also known as Firesetting · Fire-setting · Deliberate firesetting · Pyromania · Arson mental disorder · Psychotic arson · Recidivist arson · Youth firesetting · Pathological fire-setting · Forensic arson assessment
Exam-exhaustive fellowship reference on deliberate firesetting, arson, and pyromania — terminology triad, DSM/ICD exclusions and rarity, NESARC epidemiology, strong psychosis association, multi-trajectory pathways, fire-specific assessment and specialist treatment, youth and gender variants, criminal-responsibility interface, and risk-management principles without invented statute section numbers. FRANZCP-primary, globally tagged.
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Target exams
Red flags
- Untreated psychosis with threats to burn a named person or property — urgent assessment, means restriction, and lawful treatment pathway
- Inpatient or prison access to ignition means after prior firesetting — environmental fire safety is clinical risk management
- Recurrent firesetting with substance intoxication and revenge ideation — do not reassure from absence of a pyromania label
- Suicidal ideation after arson arrest or in firesetting series — suicide risk is a documented co-concern
- Court report finalised without multi-source fire investigation and psychiatric data — responsibility opinions require primary sources
- Equating arson conviction with pyromania, or pyromania with automatic legal insanity — classic exam and clinical failure
Meet the patient
A 27-year-old man is remanded after a fire in the stairwell of his mother's block of flats. Nobody was hurt. He has no prior convictions and no psychiatric file, and his sister says he stopped sleeping about five months ago.[1][5]
In the interview room he explains, calmly and in detail, that the neighbours had been pumping something through the walls and that fire was the only thing that would clear it. He also mentions that he watched the flames for a while, and that it was a relief.[5][7]
The referral letter says "?pyromania". Two questions decide this case, and neither of them is the one in the letter: which pathway is this, and what is product court has actually asked for?[1][15]
References16ShowHide
- [1]Burton PR, McNiel DE, Binder RL Firesetting, arson, pyromania, and the forensic mental health expert J Am Acad Psychiatry Law, 2012.PMID 22960918
- [2]Blanco C, Alegría AA, Petry NM, et al. Prevalence and correlates of fire-setting in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) J Clin Psychiatry, 2010.PMID 20361899
- [3]Vaughn MG, Fu Q, Delisi M, et al. Prevalence and correlates of fire-setting in the United States: results from the National Epidemiological Survey on Alcohol and Related Conditions Compr Psychiatry, 2010.PMID 20399330
- [4]Lindberg N, Holi MM, Tani P, et al. Looking for pyromania: characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting BMC Psychiatry, 2005.PMID 16351734
- [5]Anwar S, Långström N, Grann M, et al. Is arson the crime most strongly associated with psychosis? A national case-control study of arson risk in schizophrenia and other psychoses Schizophr Bull, 2011.PMID 19850668
- [6]Ducat L, Ogloff JR, McEwan T Mental illness and psychiatric treatment amongst firesetters, other offenders and the general community Aust N Z J Psychiatry, 2013.PMID 23739314
- [7]Grant JE, Won Kim S Clinical characteristics and psychiatric comorbidity of pyromania J Clin Psychiatry, 2007.PMID 18052565
- [8]Gannon TA, Ciardha CÓ, Barnoux MF, et al. Male imprisoned firesetters have different characteristics than other imprisoned offenders and require specialist treatment Psychiatry, 2013.PMID 24299093
- [9]Gannon TA, Alleyne E, Butler H, et al. Specialist group therapy for psychological factors associated with firesetting: Evidence of a treatment effect from a non-randomized trial with male prisoners Behav Res Ther, 2015.PMID 26248329
- [10]Tyler N, Gannon TA, Lockerbie L, et al. An evaluation of a specialist firesetting treatment programme for male and female mentally disordered offenders (the FIP-MO) Clin Psychol Psychother, 2018.PMID 29282790
- [11]Tyler N, Gannon TA, Ciardha CÓ, et al. Deliberate firesetting: an international public health issue Lancet Public Health, 2019.PMID 31376854
- [12]Tyler N, Gannon TA, Sambrooks K Arson assessment and treatment: the need for an evidence-based approach Lancet Psychiatry, 2019.PMID 31544760
- [13]Brett A 'Kindling theory' in arson: how dangerous are firesetters? Aust N Z J Psychiatry, 2004.PMID 15209833
- [14]Lambie I, Ioane J, Randell I, et al. Offending behaviours of child and adolescent firesetters over a 10-year follow-up J Child Psychol Psychiatry, 2013.PMID 23927002
- [15]American Academy of Psychiatry and the Law AAPL Practice Guideline for forensic psychiatric evaluation of defendants raising the insanity defense J Am Acad Psychiatry Law, 2014.PMID 25492121
- [16]Fazel S, Singh JP, Doll H, et al. Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis BMJ, 2012.PMID 22833604