From haystacks to hospitals: an evolving understanding of mental disorder and firesetting
Early literature regarding firesetting almost exclusively assumed this behavior to occur as a result of mental illness, specifically pyromania. However, over time, the etiology and nature of firesetting has been acknowledged as being highly varied. This article reviews the literature on pathological firesetting, focusing on the mental disorders that have been empirically associated with the behavior. The diagnostic and treatment dilemmas, which hinge on improved understanding about the motives for firesetting, are also considered. Following the recent publication of the DSM-5, and the retention of the pyromania diagnosis, this review provides mental health practitioners an opportunity to reflect on the assessment and treatment of firesetting with renewed understanding.