A case of trichotillomania with bulimia: combined with N-acetylcysteine synergistic therapy

Abstract Background Trichotillomania is a common type of obsessive-related disorder characterized by repetitive hair pulling, driven by escalating tension before the action and during the attempts to resist it, and causing variable hair loss. Most clinical treatments for trichotillomania have poor curative effects. Case presentationWe treated a case of trichotillomania with bulimia with N-acetylcysteine synergistic treatment. The pathological hair plucking behaviour and binge eating symptoms were both significantly improved.ConclusionThis case suggest that N-acetylcysteine can be one choice as a synergistic or adjuvant treatment for impulse control disorder. Moreover, trichotillomania and bulimia may have a common pathophysiological mechanism.

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Trichotillomania

10.2310/psych.13081 ◽

2017 ◽

Author(s):

Christine Lochner ◽

Dan Stein ◽

Eileen Thomas

Keyword(s):

Key Words ◽

Obsessive Compulsive Disorder ◽

Hair Loss ◽

Hair Pulling ◽

Obsessive Compulsive ◽

Related Disorder ◽

Compulsive Disorder ◽

Common Disorder ◽

Clinical Phenomenology ◽

Hair Pulling Disorder

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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A case of trichotillomania with binge eating disorder: combined with N-acetylcysteine synergistic therapy

Annals of General Psychiatry ◽

10.1186/s12991-021-00369-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Xudong Zhao ◽

Shikai Wang ◽

Xiujuan Hong ◽

Shaojia Lu ◽

Sufang Tang ◽

...

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Behavioral Therapy ◽

Common Type ◽

Pathophysiological Mechanism ◽

Obsessive Compulsive ◽

Case Presentation ◽

First Case

Abstract Background Obsessive–compulsive and related disorders (OCRDs) are a group of intractable and chronic mental disorders. Trichotillomania (TTM) is a common type of OCRDs characterized by repetitive hair pulling, driven by escalating tension before the action and during the attempts to resist it. Binge eating disorder (BED) is a common type of eating disorder characterized by recurrent compulsive episodes of binge eating. Both have common psychological processes (tension or impulsion) and pathological manifestations (out of control), but the pathological mechanisms are still unclear and the current clinical treatments are often unsatisfactory for these two disorders. Case presentation A 25-year-old woman with TTM comorbid BED came to our hospital for treatment. She had accepted systematic cognitive behavioral therapy (CBT) and also monotherapy or multidrug therapy with sertraline, fluvoxamine, bupropion, risperidone in full dosage and duration for 2 years, but all of them did not work. We treated this case with N-acetylcysteine (NAC) as a synergist on the basis of recent treatment (fluvoxamine 150 mg/day and bupropion 300 mg/day). The pathological hair plucking behavior and binge eating symptoms were both significantly and rapidly improved, and the follow-up in next 14 weeks showed that the effect was still maintained. Conclusion To our knowledge, this may be the first case report of using NAC as a synergist to treat TTM comorbid BED successfully, which suggest that these two disorders may have a common pathophysiological mechanism. Moreover, NAC can be one choice as a synergistic treatment for OCRDs.

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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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The effect of dopamine agonists on risk behavior in Parkinson's disease patients with and without impulse control disorder

PsycEXTRA Dataset ◽

10.1037/e512592013-083 ◽

2011 ◽

Author(s):

W. P. Van Den Wildenberg

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Risk Behavior ◽

Impulse Control ◽

Dopamine Agonists ◽

Impulse Control Disorder

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Impulse-Control Disorder

10.32388/4nim53 ◽

2020 ◽

Author(s):

Keyword(s):

Impulse Control ◽

Impulse Control Disorder

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Phenomenology and Epidemiology of Trichotillomania

10.1093/oxfordhb/9780195389715.013.0039 ◽

2012 ◽

Author(s):

Samuel R. Chamberlain

Keyword(s):

Animal Models ◽

Psychiatric Disorder ◽

Hair Loss ◽

Functional Impairment ◽

Repetitive Behaviors ◽

Hair Pulling ◽

Affect Dysregulation ◽

Obsessive Compulsive

Trichotillomania is a psychiatric disorder characterized by recurrent hair pulling, leading to hair loss and functional impairment. This chapter reviews the phenomenology and epidemiology of trichotillomania, and considers its relationship with putative obsessive-compulsive spectrum conditions and other body-focused repetitive behaviors. Salient animal models of the disorder, along with findings in human patients using neuroimaging and cognitive probes, are summarized. A brain-based model of trichotillomania is formulated, focusing on affect dysregulation, addiction, and impulse dyscontrol. Finally, the chapter flags cardinal questions for the attention of future clinical and research scrutiny.

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Hair loss in an infant presenting with failure to thrive

SAGE Open Medical Case Reports ◽

10.1177/2050313x211020220 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110202

Author(s):

Baninder Kaur Baidwan ◽

Cara J Haberman

Keyword(s):

Hair Loss ◽

Caloric Intake ◽

Failure To Thrive ◽

Filling Defect ◽

Parental Report ◽

Hair Pulling ◽

Food Material ◽

Gastric Bezoar ◽

Gastric Lumen ◽

Upper Gastrointestinal

An 11-month-old male child with a complex past medical history presented for admission due to failure to thrive. He had hair loss throughout his scalp, and his abdomen was distended. There was parental report of hair pulling and hair in his stool. An upper gastrointestinal (GI) radiograph with fluoroscopy was performed and showed a filling defect in the gastric lumen. On endoscopy, he was found to have a gastric bezoar consisting of hair, nail, and food material. The trichobezoar was removed, and he began to tolerate feeds and showed consistent weight gain. There were no recurrence of symptoms 8 months following removal. While inadequate caloric intake is a common reason for failure to thrive, mechanical obstruction from a trichobezoar as a cause is rare and to our knowledge has not been reported in a child this young.

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