A case series of trichotillomania; Impact of therapeutic intervention: Clinical out-turn

Abstract

Trichotillomania (TTM) is a less addressed cause of alopecia. Refusal to accept this condition as a psychiatric illness causes marked delay in seeking help. This article aims to evaluate the treatment response of TTM patients. This is a case series study on 5 patients (4 females, 1 male) of TTM, of whom 3 patients took treatment on an outpatient basis (obsessive-compulsive and related disorders clinic) and 2 patients at indoor (orange unit) at the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, from January 2022 to July 2023. Out of 7 cases, 2 patients did not come after the 1st follow-up. Pharmacological management was chosen according to established guidelines. All patients were given basic psychoeducation and relevant psychological intervention. A total of 5 cases were described. The median time to receive effective psychiatric treatment is 8.6 years (4–15 years). The median time to respond after starting therapy is 6 weeks. All patients responded well to selective serotonin reuptake inhibitors. Augmentation with low-dose antipsychotics and the addition of specific pharmacologic agents have been shown to improve outcomes. Psychological management helped patients most in achieving long-term remission. Despite the prolonged treatment gap, patients of TTM showed marked improvement with combined pharmacological and psychological intervention in a short time. Further study involving a more significant number of cases is needed to support the findings.

Keywords

• alopecia
• cbt
• obsessive-compulsive disorder
• selective serotonin reuptake inhibitor
• trichotillomania