Impulse control difficulty is common as symptom of the mental disorder. We can expect that secondary kleptomania is improved by treatment for the primary disease. Two Case Reports of Kleptomania in Youth Takahiko Inagaki, Tsunehiko Tanaka, Naoto Yamada Department of Community Psychiatric Medicine, Shiga University of Medical Science Different psychiatric disorders are known to cause behavioral problems, but there are few reports regarding kleptomania. Mood disorder, particularly Major Depressive Disorder, anxiety disorder, eating disorder particularly Bulimia Nervosa, and personality disorder are considered as complications. The effect of treatment seems to be large for the children with kleptomania. Nevertheless most of them do not receive attention in the healthcare setting, yet they receive judicial intervention in most cases. We report our experience of treatment for kleptomania in our institute. He came to us because of two theft cases that he had. In addition he had some problems of smoking, fighting and so on. His first antisocial act occurred while he was 5 th grader. He filched money from his parents. When he was a 7 th grader he came to resist his parents too much. When he was an 8 th grader he was in custody by police during smoking. When he was a 9 th grader he was caught by theft twice. There are no antisocial acts, but he acts suddenly. He said that he did not steal anything because he wanted it but he wanted to do nasty things. Our findings at the initial contact were as follows; General Appearance He was feeble and not seemed antisocial. He looked down, talked in a low voice and very few words. Insomnia Frequent halfway awakening. It aggravated for seven months. Depressive Mood He experienced strong depression just after getting up. Anhedonia He did not play with his friends for three months. Others Suicide feeling and decreased appetite are absent. His Mother Said, He was a very active child up to fourth grade. He lost energy in a fifth grade suddenly. Problems started occurring from that time. When he was young In both the kindergarten and the elementary school, he was considered to be a good and bright child. We started sertraline and increased gradually to 100 mg Start of therapy His mother said that his sleep was stable, and he became lively like old days. 7 weeks later His mother said that He came to be positively active and seemed to be another person compared to before start of therapy. 11 weeks later He told us “I realized the careless mistakes decreased and the trouble in the school did not occur. I feel willpower and much improved than 4 months ago.” 15 weeks later We decided that he remitted. after which his kleptomania disappeared. He came to us because of seven theft cases that he had from 9 th grade. His mother said that he stole what he had always. He said he wanted to commit a theft impulsively, and antisocial activity is not usually manifested in him. Our findings at the initial contact were as follows; General Appearance His conversation had light loose associations. Sometimes his reply avoided engaging with the question asked of him. Insomnia Originally he would sleep around seven hours, but since the days of 9 th grade he slept around only 5 hours. Hallucination After having entered high school, he experienced auditory hallucinations as comments on his behavior 6 or 7 times per day. He also sometimes had auditory hallucination that somebody talked. Delusion of Control He would fall sometimes because his body moves without permission. Thought Broadcasting He felt always his thought leaked out. Insertion of Thoughts He felt some thought invaded from the outside frequently. When he was young He was pointed out in infants examination that his development is slow. But at the age of 4 years old he was judged he had no problem. At 8 th grade, his social nature was not a problem. We started aripiprazole 3mg. We did Sleep Hygiene Instruction to take the sleep 7 hours or more every day. Start of therapy Auditory hallucination and daytime sleepiness disappeared 2 weeks later We confirmed his 7 hours sleeping per day continuously with his sleep diary. He said that his concentration was restored and his school life became easy because his hallucination disappeared. 5 weeks later We decided that he remitted. after which his kleptomania disappeared. Kleptomania is an impulse control disorder. 1. We, as medical staff, should come more into contact with patients suffering kleptomania. 2. When we diagnose and treat kleptomania, we should pay attention to treatable complications. 3. Kleptomania may disappear if we administer appropriately the treatment of the concurring complications. However, most of the children of the kleptomania do not receive medical care. In Japan most children and adolescents performing criminal activity, including theft, do not receive health care service. The Ministry of Education, Culture, Sports, Science and Technology of Japan reported that medical care and welfare intervened in only 8% of such youth cases; the school counselors in only 3%; but 11% receive judicial intervention. (fig1) Recently it is reported that individuals with kleptomania have high rates of suicide attempts.(Odlaug; 2012) fig 1 We propose the following: