Trichotillomania

Trichotillomania (hair pulling disorder), is an obsessive-compulsive spectrum disorder characterized by a long term, irresistible urge to pull out one's hair. This occurs to the degree that significant hair loss can be seen.

Prevalence is 1-2% in the general population. It affects significantly more females than males. There is a high comorbidity with OCD, excoriation disorder, body dysmorphia, and tics.

• Massachusetts General Hospital (MGH) Hairpulling Scale (A 7-item self-report)
• Psychiatric Institute Trichotillomania Scale (6-item clinician rated)
• NIMH Trichotillomania Severity/Impairment Scale

Except for clomipramine, which has shown some proven benefit in studies, SSRIs/SNRIs are generally ineffective for trichotillomania. Alternatively, antipsychotics such as those described above, may be beneficial as primary medications. Studies have also shown promising results for N-acetylcysteine and naltrexone. The main treatment for this condition is a specific type of CBT called habit reversal training.