Childhood onset trichotillomania: a retrospective analysis of 78 cases visiting tertiary general hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20163661Keywords:
Alopecia, Childhood, Comorbidity, TrichotillomaniaAbstract
Background:Trichotillomania (TTM) is an irresistible urge to pull one’s own hair and is a relatively common cause of childhood alopecia.
Methods: This is a retrospective chart review of 78 children diagnosed with TTM from September 2009 to September 2014 done in psychiatry department of a tertiary general hospital of Mumbai, India.
Results:The scalp was found to be the main site for hair pulling in most of them. Other comorbid psychiatric illnesses seen were attention deficit hyperactivity disorder (ADHD), conduct disorder and oppositional defiant disorder (ODD). Commonly prescribed medications were selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and escitalopram. Next drug widely used were second generation antipsychotics like aripiprazole.
Conclusions:This is the largest collection of childhood TTM cases published so far in Asia at least to the best of our knowledge.
References
Hallopeau H. Alopecie par grattage (trichomanie ou trichotillomanie). Ann Dermatol Syphiligr. 1889;10:440-6.
Sullivan RL, Keuthen NJ, Christenson GA, Mansueto CS, Stein DJ, Swedo SE. Trichotillomania: behavioral symptom or clinical syndrome? Am J Psychiatry. 1997;154:1442-9.
Tay YK, Levy ML, Metry DW. Trichotillomania in childhood: case series and review. Pediatrics. 2004;113(5):494-8.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Revised 4th edition. Washington, DC: American Psychiatric Association; 2000.
Diagnostic and statistical manual of mental disorders. 5th edition. Arlington, VA: American Psychiatric Association; 2013.
Christenson GA, Pyle RL, Mitchell JE. Estimated lifetime prevalence of trichotillomania in college students. J Clin Psychiatry. 1991;52(10):415-7.
Duke DC, Bodzin DK, Tavares P, Geffken GR, Storch EA. The phenomenology of hairpulling in a community sample. J Anxiety Disord. 2009;23(8):1118-25.
Wright L, Schaefer AB, Solomons G. Encyclopedia of pediatric psychology. Baltimore: University Park Press. 1979.
Mehregan AM. Trichotillomania. Archives of Dermatology. 1970;102:129-33.
Park JM, Rahman O, Murphy TK, Storch EA. Early childhood trichotillomania: initial considerations on phenomenology, treatment and future directions. Infant Mental Health Journal. 2012;33(2):163-72.
Tolin DF, Franklin ME, Diefenbach GJ, Anderson E, Meunier SA. Pediatric trichotillomania: descriptive psychopathology and an open trial of cognitive behavioral therapy. Cognitive Behav Therapy. 2007;36(3):129-44.
Lochner C, Toit PL, Dirwayi ZN, Marais A, Kradenburg J, Seedat S, et al. Childhood trauma in obsessive-compulsive disorder, trichotillomania, and controls. Depress Anxiety. 2002;15(2):66-8.
Oyekçin, Gulec D, Sahin EM, Demet MM. The child who pulls his little brothers’ hair: a different trichotillomania case. Dusunen Adam. J Psychiatry Neurol Sci. 2012;25.3.
Azrin NH, Nunn RG. Habit-reversal: a method of eliminating nervous habits and tics. Behav Res Ther. 1973;11(4):619-28.
Diefenbach GJ, Mouton OS, Stanley MA. Affective correlates of trichotillomania. Behav Res Ther. 2002;40(11):1305-15.
Woods DW, Flessner CA, Franklin ME, Keuthen NJ, Goodwin RD, Stein DJ, et al. The Trichotillomania impact project (TIP): exploring phenomenology, functional impairment, and treatment utilization. J Clin Psychiatry. 2006;67(12):1877-88.
Reeve EA, Bernstein GA, Christenson GA. Clinical characteristics and psychiatric comorbidity in children with trichotillomania. J Am Academy Child Adolescent Psychiatry. 1992;31(1):132-8.
Damodaran SS, Jayalekshmi KT, Khanna R. Trichotillomania: symptom or syndrome? a need for revision. Psychopathology. 1995;28:127-30.
Franklin M, Flessner CA, Woods DW. The child and adolescent trichotillomania impact project (CA-TIP): exploring phenomenology, functional impact, and comorbid symptoms. Developmenta Behavioral Pediatrics. 2007;29:493-500.
Franklin ME, Zagrabbe K, Benavides KL. Trichotillomania and its treatment: a review and recommendations. Expert Rev Neurother. 2011;11(8):1165-74.
