Trichotillomania: neurobiology and treatment.
Trichotillomania is a disorder characterized by repetitive hair pulling, leading to noticeable hair loss and functional impairment. This paper provides an overview of what is known of trichotillomania from several perspectives. We begin by considering historical descriptions of hair pulling that ultimately contributed to the inclusion of trichotillomania as a formal diagnostic entity in the Diagnostic and Statistical Manual. Psychological factors involved in the mediation of symptoms are examined, including positive and negative reinforcement. The relationships between trichotillomania, other body-focused repetitive behaviours, and disorders of the putative obsessive-compulsive (OC) spectrum are surveyed. The review then explores findings from the available controlled treatment trials that utilized psychotherapy, pharmacotherapy, or both. Neural circuitry involved in the manifestation of hair pulling is then identified by considering data from animal models of the condition, along with neurocognitive and neuroimaging results from patients. Finally, we highlight important areas for future neurobiological and treatment research.
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK. srchamb@gmail.com
Samuel R
SR
Chamberlain
Brian L
BL
Odlaug
Vasileios
V
Boulougouris
Naomi A
NA
Fineberg
Jon E
JE
Grant
D000818:Animals; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology; D003952:Diagnostic Imaging; D004195:Disease Models, Animal; D006120:Grooming / Q000187:drug effects / Q000502:physiology; D006184:Habits; D006801:Humans; D008960:Models, Psychological; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D016728:Self-Injurious Behavior / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D014256:Trichotillomania / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*
D011619:Psychotropic Drugs