title: Group treatment for trichotillomania: cognitive-behavioral therapy versus supportive therapy.
abstract: OBJECTIVE
  Trichotillomania is a psychiatric condition characterized by the chronic pulling and plucking of one's own hair. Cognitive-behavioral therapy shows promise as a treatment for trichotillomania and might be preferable to pharmacotherapy. However, there have been no randomized, controlled studies of the efficacy of group cognitive-behavioral therapy.
  
  
  METHODS
  We evaluated 44 subjects, recruited from April 2009 to May 2010, all of whom met DSM-IV criteria for a diagnosis of trichotillomania. Subjects were randomized to receive 22 sessions of either group cognitive-behavioral therapy or group supportive therapy (control). Treatment evaluation was non-blind and used self-report scales. The primary outcome measure was the improvement of hair-plucking behavior as assessed by the Massachusetts General Hospital Hairpulling Scale. Secondary measures included scores on the Beck Depression Inventory, the Beck Anxiety Inventory, and the Social Adjustment Scale-Self-Report.
  
  
  RESULTS
  Both groups showed significant posttreatment improvement in the scores from the Massachusetts General Hospital Hairpulling Scale (F = 23.762, P < .001) and the Beck Depression Inventory (F = 6.579, P = .003). The decrease in hair-plucking behavior over time was significantly greater in the study group than in the control group (F = 3.545, P < .038). There were no significant differences between the pretreatment and posttreatment time points or between the groups in the scores from the Beck Anxiety Inventory and the Social Adjustment Scale-Self-Report.
  
  
  CONCLUSIONS
  We conclude that group cognitive-behavioral therapy is a valid treatment for trichotillomania. This treatment model should be further revised and expanded to address comorbidities such as anxiety and social maladjustment.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01968343.
authors.affiliation: Rua Dr Ovídio Pires de Campos, 783, 3° andar. São Paulo-SP-05403-010-Brasil edsonltoledo@usp.br.
authors.forename: Edson Luiz
authors.initials: EL
authors.lastname: Toledo
authors.forename: Enilde
authors.initials: E
authors.lastname: De Togni Muniz
authors.forename: Antônio Marcelo Cabrita
authors.initials: AM
authors.lastname: Brito
authors.forename: Cristiano Nabuco
authors.initials: CN
authors.lastname: de Abreu
authors.forename: Hermano
authors.initials: H
authors.lastname: Tavares
mesh_terms: D000328:Adult; D001938:Brazil; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011615:Psychotherapy, Group / Q000379:methods*; D012657:Self-Help Groups; D014256:Trichotillomania / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*