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Available from: Dan J. Stein, Jul 04, 2015
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    ABSTRACT: Background and Objective: Trichotillomania as a comorbid disorder with schizophrenia has been described rarely. Available data suggests that in some subjects the hair pulling behaviour is secondary to psychotic symptoms. We aim to present a case of trichotillomania in a young adult with schizophrenia to add to the scarce literature available on this comorbidity. Case Description: The hair pulling behaviour in the index case was due to a strong urge, which was re-lieved by the behaviour and was not secondary to any psychotic symptoms. The course of trichotillomania was independ-ent of the course of psychotic symptoms in the index case, i.e. the partial improvement in psychotic symptoms was not accompanied by improvement in hair pulling behaviour, whereas the latter responded partially to administration of fluoxetine in addition to an antipsychotic agent. Conclusion: The index case suggests a true comorbidity between schizophrenia and trichotillomania (German J Psychiatry 2010; 13 (3): 154–156).
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    ABSTRACT: Self-mutilation (SM), the deliberate, nonsuicidal destruction of one's own body tissue, occurs in such culturally sanctioned practices as tattooing; body piercing; and healing, spiritual, and order-preserving rituals. As a symptom, it has typically been regarded as a manifestation of borderline behavior and misidentified as a suicide attempt. It has begun to attract mainstream media attention, and many more who suffer from it are expected to seek treatment. This review suggests that SM can best be understood as a morbid self-help effort providing rapid but temporary relief from feelings of depersonalization, guilt, rejection, and boredom as well as hallucinations, sexual preoccupations, and chaotic thoughts. Major SM includes infrequent acts such as eye enucleation and castration, commonly associated with psychosis and intoxication. Stereotypic SM includes such acts as head banging and self-biting most often accompanying Tourette's syndrome and severe mental retardation. Superficial/moderate SM includes compulsive acts such as trichotillomania and skin picking and such episodic acts as skin-cutting and burning, which evolve into an axis I syndrome of repetitive impulse dyscontrol with protean symptoms.
    Journal of Nervous & Mental Disease 06/1998; 186(5):259-68. DOI:10.1097/00005053-199805000-00001 · 1.81 Impact Factor
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    ABSTRACT: This review explores several aspects of trichotillomania relevant to clinical theory and practice. It is concluded that research outlining the phenomenology and patterns of comorbidity of trichotillomania have been advanced significantly in recent years. However, no current diagnostic category appropriately classifies trichotillomania. Research with nonclinical populations suggests that trichotillomania is more common than previously believed and that additional epidemiological research is warranted. Continued elaboration of existing etiological models incorporating varying theoretical perspectives is also encouraged. Assessment of trichotillomania could also be improved by the continued development of reliable and valid standardized measures. This article reviews both pharmacological and psychological treatments for trichotillomania, with an emphasis on habit-reversal training. Though some interventions appear effective in the short-term, reported relapse rates are high and future research on treatment for trichotillomania should focus on improving long-term outcomes. It is clear that despite a recent flux of research centering on trichotillomania, significant challenges for understanding and treating this psychological disorder still exist for researchers and clinicians. Based on this review of the literature, and on our clinical experience with trichotillomania, we propose directions for future research with this underserved psychiatric group.
    Clinical Psychology Review 05/2000; 20(3):289-309. DOI:10.1016/S0272-7358(98)00083-X · 7.18 Impact Factor