Severe Obsessive-Compulsive Disorder With and Without Comorbid Hair Pulling

Trichotillomania (hair pulling disorder [HPD]) is a common disorder affecting mostly women that is often underreported and underrecognized. This condition involves repetitive hair pulling resulting in hair loss with repeated unsuccessful attempts to control or stop the pulling behavior. Individuals usually attempt to conceal or camouflage the hair loss. Clinical phenomenology, neurobiology, and genetic underpinning suggest associations between obsessive-compulsive disorder and HPD. This review contains 1 table, and 19 references. Key words: hair loss, hair pulling, obsessive-compulsive and related disorder, trichotillomania

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Trichotillomania associated with a 25-hydroxy vitamin D deficiency: A case report

Mental Health Clinician ◽

10.9740/mhc.2020.01.038 ◽

2020 ◽

Vol 10 (1) ◽

pp. 38-43

Author(s):

Erika Titus-Lay ◽

Tony Joseph Eid ◽

Tiffany-Jade Kreys ◽

Bo Xuan Joshua Chu ◽

Ashim Malhotra

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

General Hospital ◽

Obsessive Compulsive Disorder ◽

Hair Loss ◽

Vitamin D3 ◽

Massachusetts General Hospital ◽

Hair Pulling ◽

Obsessive Compulsive ◽

Compulsive Disorder

Abstract Vitamin D deficiency has been correlated with non-scarring alopecia including alopecia areata or female pattern hair loss. It was theorized that hair loss secondary to vitamin D deficiency in patients susceptible to trichotillomania may exacerbate this obsessive-compulsive disorder. Though vitamin D deficiency is common, especially among patients suffering from neuropsychiatric disorders, its correlation with trichotillomania is not well reported. Two female patients suffering from trichotillomania defined by noticeable hair loss on the scalp through the Massachusetts General Hospital Hair Pulling Scale were treated to promote hair growth. Treatment included dietary supplementation with vitamin D3 1000 IU every day. It was found that in both patients treated with vitamin D3, marked improvements occurred over the span of 3 to 4 months. These included a reduction in obsessive compulsive disorder related hair loss as measured using the Massachusetts General Hospital Hair Pulling Scale, which correlated to their serum 25-hydroxyvitamin D levels. Experimental and clinical evidence is available to explain the underlying physiology and its probable relationship to trichotillomania's pathophysiology.

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A Neurocognitive Comparison of Pediatric Obsessive-Compulsive Disorder and Trichotillomania (Hair Pulling Disorder)

Journal of Abnormal Child Psychology ◽

10.1007/s10802-020-00627-6 ◽

2020 ◽

Vol 48 (5) ◽

pp. 733-744 ◽

Cited By ~ 1

Author(s):

Emily P. Wilton ◽

Christopher A. Flessner ◽

Elle Brennan ◽

Yolanda Murphy ◽

Michael Walther ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Hair Pulling ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Hair Pulling Disorder

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Trichotillomania, Obsessive-Compulsive Disorder, and Tourette Syndrome: Comorbid Relationships and Risks for Expression

CNS Spectrums ◽

10.1017/s1092852900006659 ◽

1998 ◽

Vol 3 (10) ◽

pp. 49-51 ◽

Cited By ~ 3

Author(s):

Richard L. O'Sullivan ◽

Euripedes C. Miguel ◽

Barbara Coffey ◽

Scott L. Rauch ◽

Cary Savage ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Tourette Syndrome ◽

Phenomenological Study ◽

Tic Disorders ◽

Dopamine Antagonists ◽

Hair Pulling ◽

Structured Interviews ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Neuroimaging Data

AbstractTrichotillomania (TTM, repetitive hair pulling) is a complex underdiagnosed syndrome that often causes considerable psychological distress and physical disfigurement. Although many aspects of hair pulling bear similarity to compulsions of obsessive-compulsive disorder (OCD), TTM lacks obsessions associated with OCD. The phenomenology of TTM also is similar to tics in Tourette Syndrome (TS) and overlaps with TS in both limited structural neuroimaging data and in terms of treatment response to pharmacotherapy with dopamine antagonists.In order to study potential comorbid relationships between TTM, TS, and OCD, a total of 61 patients with either TS, OCD, or OCD comorbid with TS were assessed using structured interviews as part of a phenomenological study of these groups. Post hoc analyses indicated significantly higher proportions of hair pulling in those subjects with OCD comorbid with TS compared to subjects with either OCD or TS alone.These data, in conjunction with clinical phenomenology, neuroimaging results, and response to pharmacotherapy suggest the possibility that some forms of TTM may be more closely related to tic disorders than OCD. Futher research is needed to clarify and confirm these observations of putative relationships between TTM and TS and potential treatment implications.

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Trichotillomania: A Case Study

International Journal of Indian Psychology ◽

10.25215/0501.060 ◽

2017 ◽

Vol 5 (1) ◽

Author(s):

Phoram P Trivedi ◽

Kalrav H Mistry

Keyword(s):

Obsessive Compulsive Disorder ◽

Impulse Control ◽

Body Dysmorphic Disorder ◽

Impulse Control Disorder ◽

Vicious Cycle ◽

Hair Pulling ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Physical Discomfort

Present study is about Trichotillomania. As per APA (2013) Trichotillomania diagnostically is an impulse control disorder which shows some overlap with compulsive features of OCD (Obsessive compulsive disorder) and some with BDD (Body dysmorphic disorder). Trichotillomania is usually as a result of first exposure to some hair pulling event and relating it with unhelpful cognitions which eventually lead to a vicious cycle. Therapeutically, it is important to investigate how the first exposure to a random hair pulling event gets associated with a series of unhelpful thoughts that make the patient think that until they pull hair, the anxiety and physical discomfort will not be reduced.

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