Trichotillomania With Trichophagia, Progressive Psychosis-Like Symptoms and Disinhibition, Following Suspected Frontal Traumatic Brain Injury: A Case Report

This case report discusses a 28-year-old male who developed trichotillomania (TTM) with trichophagia, along with psychosis-like symptoms and disinhibition, following a suspected frontal traumatic brain injury (TBI) from a motor vehicle accident five years prior. Despite unremarkable CT findings, the patient exhibited severe behavioral disturbances, including compulsive hair-pulling, aggression, and hallucinations. Treatment with risperidone, quetiapine, fluvoxamine, and promethazine led to partial improvement, but the family discharged him against medical advice before further diagnostic tests could be completed. The case underscores the potential for TTM to emerge as a post-traumatic syndrome and highlights the need for a comprehensive, multidisciplinary approach to treatment that addresses psychiatric, neurological, and rehabilitative needs.