"Similarly, the rate of trichotillomania in this study (1.4% current) was similar to those found in the general population (1.0%–2.5%) (Christenson et al., 1991; Rothbaum et al., 1993). Therefore, this study suggests that the grooming disorders may be more common in youth with OCD than in the general population. "
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine current prevalences, clinical correlates and patterns of co-occurrence of impulse-control disorders (ICDs) in children and adolescents with obsessive-compulsive disorder (OCD). We examined rates and clinical correlates of comorbid ICDs in 70 consecutive child and adolescent subjects with lifetime DSM-IV OCD (32.9% females; mean age = 13.8 +/- 2.9 years). Comorbidity data were obtained with structured clinical interviews using DSM-IV criteria. OCD severity was assessed with the Child Yale-Brown Obsessive-Compulsive Scale. All variables were compared in OCD subjects with and without current ICDs. 12 (17.1%) subjects met criteria for a current ICD. Pathological skin picking and compulsive nail biting were the most common ICDs with current rates of 12.8% and 10.0%, respectively. OCD subjects with current ICDs were significantly more likely to have a co-occurring tic disorder (66.7% vs. 20.7%). Although having an ICD was associated with greater numerical scores of OCD symptomatology, these differences were not statistically significant. There were no sex-specific patterns of ICD occurrence in children and adolescents with OCD. Certain ICDs are common among children and adolescents with OCD. Better identification of ICDs in children and adolescents with OCD is needed, as are empirically validated treatments for youth with co-occurring ICDs.
Psychiatry Research 12/2009; 175(1-2):109-13. DOI:10.1016/j.psychres.2009.04.006 · 2.47 Impact Factor
"Although early reports (e.g. Mannino & Delgado, 1969) described child and adolescent TTM as a very rare condition, more recent studies using epidemiological and student samples of older adolescents and young adults estimate the prevalence of clinically significant pulling to range between 1% and 3.5% (Christenson, Pyle, & Mitchell, 1991; King, Zohar et al., 1995; Rothbaum, Shaw, Morris, & Ninan, 1993). The prevalence of TTM among younger children remains unknown. "
[Show abstract][Hide abstract] ABSTRACT: In study 1, 46 children and adolescents with trichotillomania who sought treatment at 2 specialty outpatient clinics were assessed. Most children reported pulling hair from multiple sites on the body, presented with readily visible alopecia, reported spending 30-60 minutes per day pulling or thinking about pulling, and reported experiencing significant distress about their symptoms. Most were described by their parents as having significant problems in school functioning. Few children met criteria for obsessive-compulsive disorder or tic disorder. Child and family rates of other forms of psychopathology were high. In study 2, 22 of these children were enrolled in an open trial of individual cognitive behavioral therapy with particular attention to relapse prevention. Trichotillomania severity decreased significantly and 77% of children were classified as treatment responders at post-treatment and 64% at 6-month follow-up.
"Prevalence is even higher when certain criteria (i.e. increased tension before hair pulling and gratification after hair-pulling) are omitted (Christenson et al., 1991b; Rothbaum et al., 1993). Trichotillomania is accompanied by significant distress and impairment (Diefenbach et al., 2005), and can lead to significant morbidity (Bouwer and Stein, 1998). "
[Show abstract][Hide abstract] ABSTRACT: There is a need for an effective medication for the treatment of trichotillomania (TTM), which is an impulse control disorder characterized by chronic hair-pulling. Topiramate has shown promising results in the treatment of impulse-control disorders. The present open-label pilot study investigated the efficacy and safety of topiramate in 14 adults with TTM. Patients received 16 weeks of flexible dose treatment (50-250 mg/day), followed by a flexible dose taper over 2-4 weeks. The primary outcome measure was the Massachusetts General Hospital Hair-Pulling Scale (HPS), whereas secondary outcome measures were the Clinical Global Impression (CGI) Scale, the Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Anxiety and the Disability Profile. A repeated measures analysis of variance on the intent-to-treat sample was implemented to evaluate treatment response. The primary outcome measure (HPS) indicated that the severity of hair-pulling in adults with TTM who completed the 16-week study (n=9) decreased significantly from baseline to the treatment endpoint (F=5.05; P=0.0002). Although the CGI-Improvement scores suggested that hair-pulling was not significantly reduced, six of nine trial completers were classified as responders. None of the other measures showed significant differences compared to baseline. Five patients dropped out owing to adverse effects. These results suggest that topiramate may be useful in the treatment of TTM. Future studies should investigate the efficacy of topiramate in an appropriately powered randomized placebo-controlled trial.
International Clinical Psychopharmacology 10/2006; 21(5):255-9. DOI:10.1097/00004850-200609000-00002 · 2.46 Impact Factor
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