Trichotillomania: Chronic Disorder Characterized by Compulsive Hair Pulling

Trichotillomania (TTM) is a chronic disorder characterized by compulsive hair pulling, resulting in significant hair loss and psychological distress. It is more prevalent in females and usually starts between ages 5 and 12, with a more challenging prognosis if onset occurs in adulthood. TTM is often comorbid with anxiety, depression, and other psychiatric disorders. Diagnosis is difficult due to the patient's often secretive behavior. Treatment primarily involves cognitive-behavioral therapy, specifically habit reversal training, and pharmacotherapy, with clomipramine being the most effective drug according to controlled trials. SSRIs and neuroleptics have also shown potential in uncontrolled studies. The document suggests that genetic factors, serotonin deficiency, and abnormal brain metabolism may contribute to the development of TTM.