Under-diagnosed psychiatric syndrome I:
trichotillomania
by
Ko SM
Department of Psychological Medicine,
National University of Singapore, Singapore.
Ann Acad Med Singapore 1999 Mar; 28(2):279-81

ABSTRACT

Trichotillomania is a chronic psychiatric condition characterised by uncontrollable, self-inflicted, hair pulling, resulting in noticeable hair loss. The hair pulling may occur anywhere on the body; with the scalp and eyelashes most commonly affected. Onset is often during childhood or early adolescence. Once presumed to be an obscure condition, the estimated lifetime prevalence is 1.5% for male and 3.4% for female college students. In very young patients, a more equal sex ratio is observed. On the whole, women show 5 to 10 times higher prevalence rates than men. Majority of the sufferers disguise their hair loss very well. Because of the secrecy and shame about their behaviour, many remain silent sufferers, and treatment is often delayed. Serotonin reuptake inhibitors currently are the pharmacological treatment of choice, although other drugs like naltrexone and antipsychotics like pimozide and haloperidol have varying responses. Behaviour therapy includes habit reversal coupled with exposure therapy and response prevention.

OCD
SSRIs
Sertraline
Fluoxetine
Citalopram
Paroxetine
Fluvoxamine
OCD therapies
Eating disorders
Trichotillomania

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