Trichotillomania. An obsessive compulsive spectrum disorder?
Trichotillomania is a neglected neuropsychiatric disorder that only recently has received research attention. Based on clinical data, it appears far more common than previously believed. Like OCD, the behavior is recognized as senseless and undesirable, but is chronic and difficult to treat. The comorbidity, drug response data, familiality, and phenomenology of the disorder extend the concept of OCD to a spectrum of inappropriately released, excessive grooming behaviors. Although the discovery of clomipramine's effectiveness has provided relief to some trichotillomanics, further work is indicated to find regimens that provide long-term suppression of symptoms. Ongoing investigations of early-onset trichotillomania may reveal etiologic triggers, whereas studies that examine the similarities and differences between trichotillomania and OCD may help define the neurobiology of OCD, and possibly of other atypical impulse control disorders.
Swedo
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SE
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Leonard
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HL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002997:Clomipramine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003891:Desipramine / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D014256:Trichotillomania / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology
D002997:Clomipramine; D003891:Desipramine