Trichotillomania: A Review of Diagnosis and Treatment

The 2001 document reviews Trichotillomania (TTM), an impulse control disorder causing individuals to pull out their hair, resulting in hair loss and psychological distress. Diagnosis is difficult due to patient denial or ignorance, and specialized scalp biopsies are often necessary. The most promising treatment mentioned is clomipramine, a tricyclic antidepressant, which in one study led to a 50% or greater reduction in symptoms for 12 out of 13 patients, although its long-term efficacy and tolerability are questionable. Other medications like SSRIs have shown mixed results. Habit reversal training is recommended as an effective behavioral therapy. TTM typically starts in late childhood or adolescence and is frequently comorbid with other psychiatric disorders. The document emphasizes the need for more tolerable medications, accessible therapy, and further research into early onset TTM and treatment efficacy.