Because pyromania is such a rare disorder, we don't know much about its biological causes. Pyromania is generally classified as an impulse control disorder (ICD), along with pathological gambling, kleptomania and addictions. We don't know what sparks most ICDs, but they don't go away on their own accord -- patients need medical and psychiatric treatment.
Of the ICDs, pathological gambling and kleptomania are the best studied [source: Dell'Osso]. Here, the serotonin centers of the brain seem to be affected. So, most treatments involve behavioral therapy (like biofeedback) in combination with pharmacologic treatments with selective serotonin reuptake inhibitors (see How Antidepressants Work). But, in contrast to other ICDs, pyromania is often treated with behavioral therapy.
In a 2006 letter to the editor of the Journal of Clinical Psychiatry, psychiatrist Jon Grant reported a case of one patient who fit the clinical definition of pyromania. Grant was able to examine the brain of this patient with SPECT imaging and found a region in the left inferior frontal portion that had a low blood flow [source: Grant]. The patient underwent three weeks of daily behavioral therapy and a daily regimen of topiramate, an anticonvulsant used to treat seizures, for 12 months. During that time, the patient reported a substantial decrease in his urge to set fires. When Dr. Grant reimaged the patient's brain, the problem was gone. The patient continued to be symptom-free while on the medication. This is the first report of a possible biological cause for pyromania and combination drug and behavioral treatment for it.
So, much about pyromania remains a mystery. Psychiatrists still debate whether it is a real mental illness or not. We do know that many people confuse pyromania with arson and that, according to its clinical definition, it's extremely rare. Recent reports suggest that there may be a biological cause and possible pharmacological treatment, but it's too early to tell.
For more information about pyromania, check out the links on the next page.