Trichotillomania – A case report on online treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S559-S559
Author(s):  
S. Onrust ◽  
V. Nunic
Keyword(s):  
Case Report ◽  
Behavioural Therapy ◽  
Panic Attacks ◽  
Traumatic Experiences ◽  
Reversal Training ◽  
Hair Pulling ◽  
Frustration Tolerance ◽  
Self Confidence ◽  
Pull Out ◽  
Habit Reversal Training

IntroductionICD-10 classifies trichotillomania (TTM) as one of the habit and impulse disorders. It is characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. Persons suffering from TTM often hide it. TTM is often unrecognised by doctors, treated by dermatologists or untreated, causing a lot of suffering.ObjectiveTo present treatment of trichotillomania.AimTo present one case report of trichotillomania treated online.MethodsThis is case report of female patient with TTM untreated 13 years. She had earlier been treated for depression and had multiple traumatic experiences. Patient both self-diagnosed TTM and asked for treatment online. During two months, there were 7 sessions and 2 follow-ups. Sessions were online and based on Habit Reversal Training (HRT) and Rational Emotional Behavioural Therapy (REBT). The following issues were addressed: hair pulling, shame, guilt, low self-confidence, assertiveness, low frustration tolerance, panic attacks, sadness. No medications were used.ResultsHair pulling has almost completely stopped. Social functioning and self-acceptance were improved. Guilt and shame have reduced, self-confidence and frustration tolerance have increased.ConclusionHRT and REBT online treatments have reduced hair pulling and the associated emotional problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Trichotillomania: What Do We Know So Far?

2021 ◽  
pp. 1-7
Author(s):  
Daniel Fernandes Melo ◽  
Caren dos Santos Lima ◽  
Bianca Maria Piraccini ◽  
Antonella Tosti
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Treatment Plan ◽  
Interdisciplinary Approach ◽  
Comprehensive Treatment ◽  
Reversal Training ◽  
Pharmacological Management ◽  
Related Disorder ◽  
Pull Out ◽  
Habit Reversal Training

Trichotillomania is defined as an obsessive-compulsive or related disorder in which patients recurrently pull out hair from any region of their body. The disease affects mainly female patients, who often deny the habit, and it usually presents with a bizarre pattern nonscarring patchy alopecia with short hair and a negative pull test. Trichoscopy can reveal the abnormalities resulting from the stretching and fracture of hair shafts, and biopsy can be necessary if the patient or parents have difficulties in accepting the self-inflicted nature of a trichotillomania diagnosis. Trichotillomania requires a comprehensive treatment plan and interdisciplinary approach. Physicians should always have a nonjudgmental, empathic, and inviting attitude toward the patient. Behavioral therapy has been used with success in the treatment of trichotillomania, but not all patients are willing or able to comply with this treatment strategy. Pharmacotherapy can be necessary, especially in adolescents and adult patients. Options include tricyclic antidepressants, selective serotonin reuptake inhibitors, and glutamate-modulating agents. Glutamate-modulating agents such as N-acetylcysteine are a good first-line option due to significant benefits and low risk of side effects. Physicians must emphasize that the role of psychiatry-dermatology liaison is extremely necessary with concurrent support services for the patient and parents, in case of pediatric patients. In pediatric cases, parents should be advised and thoroughly educated that negative feedback and punishment for hair pulling are not going to produce positive results. Social support is a significant pillar to successful habit reversal training; therefore, physicians must convey the importance of familial support to achieving remission. This is a review article that aims to discuss the literature on trichotillomania, addressing etiology, historical aspects, clinical and trichoscopic features, main variants, differential diagnosis, diagnostic clues, and psychological and pharmacological management.

scholarly journals Coronavirus disease-19 Pandemic-Induced Panic Disorder

2021 ◽  
Vol 9 (T3) ◽  
pp. 237-239
Author(s):  
Muhammad Surya Husada ◽  
Mustafa M. Amin ◽  
Munawir Saragih
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Panic Disorder ◽  
Panic Attack ◽  
Respiratory Symptoms ◽  
Panic Attacks ◽  
Psychosocial Burden ◽  
Her Family ◽  
Common Diagnosis ◽  
The Individual

Background: COVID-19 is a newly emerging infectious disease which is found to be caused by SARS-2. COVID-19 pandemic has spread worldwide causing a rapidly increasing number of mental disorders cases, primarily anxiety disorder. Since majority of panic disorder patients are present with great anxiety in response to their physical or respiratory symptoms, support and encouragement from psychiatrist or therapist are fundamental to alleviate the severity of the symptoms. Case Report: We reported a case of COVID-19 induced panic disorder in a woman, 52 years old, batak tribe who started to experience multiple panic attacks since one of her family members was confirmed to be Covid-10 positive. Conclusion: In general, panic disorder is a common diagnosis, but this case appeared to be interesting as it is induced by COVID-19 pandemic. As in this case, the individual who experienced multiple panic attack is not even a COVID-19 patient but has one of her family member affected by the virus. A wide body of evidence has shown that this pandemic massively contributes to worsening of psychosocial burden in nationwide.

scholarly journals Effectiveness of behaviour therapy for children and adolescents with Tourette syndrome and chronic tic disorder in a real-world setting

2020 ◽  
Author(s):  
Per Andrén ◽  
Vera Wachtmeister ◽  
Julia Franzé ◽  
Caroline Speiner ◽  
Lorena Fernández de la Cruz ◽  
...  
Keyword(s):  
Young People ◽  
Tourette Syndrome ◽  
Real World ◽  
Post Treatment ◽  
Reversal Training ◽  
Behaviour Therapy ◽  
Tic Disorder ◽  
Chronic Tic Disorder ◽  
Habit Reversal Training ◽  
Tic Severity

Background: Treatment guidelines recommend behaviour therapy (BT) as the first-line intervention for patients with Tourette syndrome (TS) and chronic tic disorder (CTD). The efficacy of BT has been documented in randomised controlled trials (RCTs), but it is unclear to what extent these results are generalisable to real-world clinical settings, and whether the therapeutic gains are maintained long-term.Methods: In this naturalistic study, 74 young people with TS/CTD (aged 6 to 17) received BT (including psychoeducation, exposure with response prevention, habit reversal training or a combination of these treatments) at a specialist clinic in Stockholm, Sweden. Data were routinely collected at baseline, post-treatment, and at 3-, 6-, and 12-month follow-ups. Measures included the clinician-rated Yale Global Tic Severity Scale (YGTSS) and the Clinical Global Impression – Improvement scale (CGI-I), amongst others.Results: Tic severity and tic-related impairment (as measured by the YGTSS) improved significantly after treatment, with large within-group effect sizes (d=1.03 for the YGTSS Total Tic Severity Score, and d=1.37 for the YGTSS Impairment Score). At post-treatment, 57% of the participants were classified as treatment responders according to the CGI-I. Both tic severity and tic-related impairment continued to improve further through the follow-up, with 75% of the participants being rated as responders 12 months after the end of treatment. Significant improvements were also observed across a range of secondary measures.Conclusions: BT is an effective and durable treatment for young people with TS/CTD in a real-world clinical setting, with effects comparable to those reported in RCTs.

Case report: panic attacks as symptom of aortic regurgitation and aneurysm

2018 ◽  
Vol 108 (4) ◽  
pp. 448-451
Author(s):  
Christian Spies ◽  
Ulrich Laufs ◽  
Andreas Hagendorff ◽  
Michael Metze
Keyword(s):  
Case Report ◽  
Aortic Regurgitation ◽  
Panic Attacks

Psychotherapy and refugees

2021 ◽  
pp. 493-502
Author(s):  
Francesca Brady ◽  
Cornelius Katona ◽  
Eileen Walsh ◽  
Katy Robjant
Keyword(s):  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Model Of Care ◽  
Narrative Exposure Therapy ◽  
Psychotherapeutic Interventions ◽  
Appropriate Treatment ◽  
Cognitive Behavioural ◽  
Post Traumatic

This chapter explores effective psychotherapeutic interventions for treating post-traumatic stress disorder in adult vulnerable migrants, including cognitive behavioural therapy (CBT), eye movement desensitization and reprocessing, and narrative exposure therapy. An overview of the evidence for these treatments is discussed, as well as how these can be implemented effectively for vulnerable migrants who face ongoing instability and uncertainty, as well as multiple barriers to accessing appropriate treatment. The additional needs of vulnerable migrants are therefore also highlighted. The chapter proposes that to assist individuals effectively in recovering from their traumatic experiences, support must be offered to address these needs, alongside any psychological treatment. A service case example is presented to highlight how an integrated model of care can most effectively meet the needs of vulnerable migrants.

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