Pyromania

For an Active Fire, Get Outside and Call 911

If a fire is burning in your home, get outside to your meeting place and stay there. Tell the fire department if someone is trapped inside.¹

The U.S. Fire Administration advises calling 911 from the outside meeting place.² Getting people to safety comes before discussing why the fire started.

What Is Pyromania?

Pyromania is an impulse-control disorder involving repeated, deliberate firesetting, increasing tension beforehand and gratification afterward.³ An ordinary interest in fire or one incident does not, by itself, establish that recurring clinical pattern.

For example, enjoying a supervised campfire does not demonstrate repeated firesetting driven by tension and relief. At the same time, a single unsafe incident still deserves a safety response. You do not need to decide whether the word pyromania applies before keeping ignition sources away from a child or asking for professional advice.

Pyromania belongs within the broader subject of impulse-control disorders. Describing the actual urges and behavior is more useful than labeling someone a “pyromaniac.”

How Do Pyromania, Firesetting and Arson Differ?

Firesetting describes behavior, arson refers to a criminal offense, and pyromania names a psychiatric diagnosis.⁴ These terms answer different questions and should not be used interchangeably.

• Firesetting: What did the person do?
• Arson: Does the act fall within a criminal legal category?
• Pyromania: Does the person’s history and clinical assessment support this particular mental health diagnosis?

The legal label does not explain the person’s symptoms or motives. Likewise, a mental health diagnosis does not, by itself, answer legal questions. A clinician needs to understand the circumstances rather than infer pyromania from the fact that a fire occurred.

As an illustrative contrast, “I wanted to damage property” and “I felt mounting tension and then relief” describe different experiences. Neither statement alone determines a diagnosis. Both call for questions about safety, purpose, context and what happened before and after the act.

Seek Assessment Before Acting on Recurring Fire-Related Urges

Recurring urges to set fires, growing difficulty resisting them or a repeated tension-and-relief pattern deserve professional assessment. You do not need to set a fire before asking for help. Urges alone do not establish the repeated firesetting pattern associated with pyromania, but they give a clinician something important to assess.

A 2012 clinical review described stress, boredom, feelings of inadequacy and interpersonal conflict as reported triggers in one small study of people with pyromania. Some participants reported no identifiable trigger.⁵ These observations are useful conversation starters, not a profile that everyone must match.

Before an appointment, consider writing down:

• The urges: When they happen, how often they return and whether resisting them is becoming harder.
• What comes before: Tension, conflict, boredom, substance use or other circumstances you notice.
• What follows: Relief, excitement, distress, regret or another response, whether or not you acted.
• Any incidents or preparation: What happened, who could have been harmed and whether you currently have access to matches or lighters.
• What helps you stay safe: People you can contact and situations in which you have successfully stepped away.

Relief after firesetting does not necessarily mean a person feels good about its consequences. The same 2012 review also described substantial distress after firesetting in the small study it discussed.⁵ Tell the clinician about both the immediate response and how you feel later.

How Is Pyromania Assessed?

A clinician evaluates the history and context of fire-related urges or incidents, rather than diagnosing pyromania from an interest in fire. The features described are not a diagnostic checklist. Assessment can identify a need for help even when pyromania is not the eventual diagnosis.

The purpose of firesetting matters because the same outward behavior can occur in different circumstances. Explain what you hoped the fire would accomplish, whether alcohol or drugs were involved, and what was happening with your mood, sleep and perceptions. Those details help the clinician distinguish an accompanying condition from a condition that may better explain the behavior.

For example, someone reporting a voice telling them to set a fire needs assessment of that experience, not just questions about fascination with fire. This is an example of why context matters, not a rule for diagnosing or excluding any condition.

A useful assessment should address:

• Immediate safety: Current urges, intent to act, access to ignition sources and who may be at risk.
• The history: Previous incidents, the sequence before and after them, changes over time and attempts to resist urges.
• Other concerns: Mood symptoms, unusual perceptions, attention or behavior difficulties and substance use.
• The care needed: Whether urgent evaluation is necessary, what treatment or specialist referral to pursue, and how follow-up will work.

Example appointment wording: “I’m having repeated urges to set fires. I have not acted on them, but I’m worried about resisting them. Can we assess what is happening and make a plan for safety?” If fires have occurred, say so directly and describe the circumstances.

Pyromania Is Described as Rare, but Small Studies Cannot Establish a U.S. Rate

Pyromania is described as rare in the clinical literature, but the studies discussed here do not establish a U.S. population rate. A 2012 clinical review stated that overall prevalence in adult populations was unknown.⁵ That dated finding should not be turned into a precise current national estimate.

Clinical Studies Describe Accompanying Conditions, Not Everyone With Pyromania

A 2007 study of 21 adolescents and adults with lifetime pyromania found that 18 reported urges to set fires and 13 had a current mood disorder. Participants were recruited from inpatient and outpatient studies of impulse-control disorders.⁶ This selected clinical sample cannot tell us how common pyromania is in the general population.

A 2026 chart review examined 12 patients aged 9 or older who had documented clinical diagnoses of pyromania at one psychiatric hospital in the Bronx.³ The records covered admissions from December 2013 through 2023. Psychotic disorders and substance use disorders were each recorded in about 58% of that small sample.³

Those records show that other diagnoses may need attention during care. They do not establish national prevalence, prove why someone developed pyromania or show that people with psychotic disorders generally set fires. A diagnosis appearing alongside pyromania in a chart also does not explain the circumstances of every incident.

A 2025 systematic review included five studies examining ADHD alongside pyromania or firesetting in children and adolescents and reported an association between these concerns.⁷ Because the review combined a behavior with a specific diagnosis, its findings should not be read as showing that children who set fires all have pyromania, or that ADHD causes it.

For a family, the practical lesson is to describe attention, behavior and fire-related concerns together during assessment. Do not use a study’s participant profile to decide whether a particular child does or does not need help.

The Cited Clinical Studies Do Not Establish What Causes Pyromania

The observational findings above do not establish a cause of pyromania. Finding two conditions in the same person does not show that one caused the other. The studies also cannot determine why a particular person developed fire-related urges.

Instead of assuming a cause, bring a timeline to the appointment: when the urges began, when other symptoms appeared and what was happening around each incident. That gives the clinician useful information without requiring you to explain the condition yourself.

Is Pyromania a Fire Addiction?

Pyromania is classified as an impulse-control disorder, not a diagnosis of substance addiction. A substance use disorder can coexist with pyromania, as the small hospital study illustrates, but that does not establish that either condition causes the other.

If alcohol or drugs are part of the picture, describe when use occurs in relation to the urges or incidents. Both concerns need attention rather than an assumption that treating one automatically resolves the other. Our dual diagnosis guide provides broader information about assessment and care when mental health and substance-use concerns overlap.

Pyromania Treatment

Treatment planning for pyromania can focus on managing fire-related urges, reducing opportunities for harm and addressing other identified mental health or substance-use conditions. The evidence does not justify promising a particular therapy, medication or cure. A useful plan should still specify what to do when urges return and when to seek more urgent help.

CBT Has Shown Promise, Not a Guaranteed Result

A 2012 clinical review described cognitive behavioral therapy, or CBT, as showing promise for pyromania.⁵ That is limited evidence, not a guarantee of effectiveness or proof of a cure.

Possible therapy goals to discuss include recognizing the sequence leading to an urge, examining the thoughts that accompany it, rehearsing safer responses and deciding how a trusted person can help. These are practical examples of treatment-planning questions, not a validated self-treatment program.

For example, a therapist and patient might agree on a response to tension after an argument: leave the area containing matches or lighters, contact an agreed support person and use a coping skill practiced in therapy. The point is to make the safer response specific before the next difficult moment. Do not test progress by deliberately exposing yourself to fire.

Medication Decisions Require an Individual Assessment

A 2022 systematic review found eight randomized medication trials for impulse-control disorders: six for intermittent explosive disorder and two for kleptomania. None of the included trials studied pyromania.⁸ Results for those other disorders should not be presented as proven medication benefits for pyromania.

This finding does not prove that every medication is ineffective. It describes the trials included in a 2022 review, not all research that might appear afterward. It also means that a medication list alone cannot tell a reader what treatment is appropriate.

A prescriber can assess whether another diagnosed condition needs medication. If a medicine is considered for fire-related symptoms, ask about the reason for choosing it, the uncertainty, possible harms and the monitoring plan.

Questions to ask: “Which symptom or condition is this medicine meant to treat? How will we judge whether it is helping? What side effects should I report, and when will we review the plan?”

Follow-Up Should Review Urges as Well as Incidents

A practical follow-up discussion should cover whether urges are changing, whether the safety plan is usable and whether other symptoms need attention. Reporting no new fires is important, but tell the clinician if urges remain intense or access to ignition sources has changed.

Ask who to contact if the plan stops feeling sufficient. For a child, also clarify the caregiver’s role in supervision, appointments and communication with the professionals involved.

Families Can Make Surroundings Safer While Arranging Care

A parent or family member can work on fire safety now while arranging mental health care for recurring urges or firesetting. Neither step needs to wait for a diagnosis of pyromania. Use concrete precautions and a calm conversation rather than relying on a promise that it will not happen again.

For Children, Limit Access and Practice Household Fire Safety

The U.S. Fire Administration recommends keeping matches and lighters away from children, supervising children, checking the home for fire hazards, maintaining working smoke alarms on every level and inside and outside sleeping areas, and planning and practicing a home escape plan.⁹

Start with a household check today. Make sure children cannot access matches or lighters, decide who is supervising them and review the outside meeting place. Fire safety is a household responsibility, not something a child should be expected to manage alone.

For an adult worried about their own urges, a practical precaution to discuss with a trusted person is temporarily limiting access to matches and lighters. Agree on whom to contact when urges intensify. This is a safety suggestion, not a substitute for assessing the urges.

A Useful Conversation Starts With Observations and Concern

Ask what has been happening without assigning a label. Keep the conversation focused on understanding the urges or incident and deciding what will make the situation safer.

Example family conversation: “I care about you, and I’m concerned about the fire-related urges you told me about. What happens before the urge, and what helps you step away? Let’s put the matches and lighters out of reach and contact someone who can assess this with us.”

For a child, ask what they were trying to do and explain clearly that fire is not a toy. The U.S. Fire Administration notes that curiosity about fire is common in children and that youth firesetting can have different motives, including experimentation, thrill-seeking, distress or an intent to cause destruction.⁹ Do not assume curiosity explains every incident.

Fire-Safety Education and Mental Health Assessment Have Different Jobs

Fire-safety education teaches prevention and safe responses. Mental health assessment evaluates the person’s urges, behavior, symptoms and care needs. A fire-safety lesson should not be treated as a mental health evaluation.

The U.S. Fire Administration recommends contacting the local fire department for help teaching fire safety when a child may be at higher risk of experimenting with fire.⁹ Ask what youth education is available locally, while separately arranging clinical assessment when there are recurring urges, repeated incidents or other mental health concerns.

Seek Care by Describing the Fire-Related Concern Directly

Start with a primary care clinician, a child’s pediatrician or a licensed mental health professional, and explain the fire-related concern when requesting an appointment. Ask whether the clinician can assess firesetting and impulse-control concerns or arrange an appropriate referral.

If you think you may act on an urge now, move away from ignition sources and seek urgent in-person assessment rather than waiting for a routine appointment. If a fire has started, get outside and call 911.

For a routine appointment, bring your notes about urges, incidents, substance use, other symptoms and current safety precautions. Ask:

• “Can you assess both the fire-related behavior and other possible mental health concerns?”
• “What should our safety plan include before the next appointment?”
• “What changes would mean we need more urgent care?”
• “If this is outside your experience, where can you refer us?”

If using insurance, ask your insurer for in-network mental health clinicians, then contact the practice to check its experience and availability. An insurance listing alone does not establish expertise in pyromania.

If substance use is also a concern, our Find Treatment Help page is a broader addiction-care resource. It is not a verified directory of pyromania specialists or an emergency service. The first priority is an assessment that fits the person’s fire-related concerns and current safety needs.

For emotional distress or a suicidal crisis in the United States, call or text 988.

Written by

Jessica Miller

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

Reviewed by

• Fact-Checked
• Editor

Kent S. Hoffman, D.O.

Co-Founder & Chief Medical Officer

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.