The Experts below are selected from a list of 4575 Experts worldwide ranked by ideXlab platform
Jon E Grant - One of the best experts on this subject based on the ideXlab platform.
-
Prevalence, gender correlates, and co-morbidity of Trichotillomania
Psychiatry research, 2020Co-Authors: Jon E Grant, Darin D. Dougherty, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a mental health condition characterized by repetitive pulling out of one's hair, often leading to functional impairment and/or distress. A convenience sampling of 10,169 adults, aged 18–69 years, representative of the general US population, completed a survey to establish occurrence of Trichotillomania, other mental health concerns, and impact of the illness. 175 (1.7%) identified as having current Trichotillomania. Rates of Trichotillomania did not differ significantly based on gender (1.8% of males and 1.7% of females). The mean age of onset for Trichotillomania was 17.7 years. The mean age of onset differed significantly for males (mean 19.0 years) versus females (mean 14.8 years (p = 0.020). The average amount of distress reported due to Trichotillomania was relatively high, and 79% of people with Trichotillomania had one or more mental health comorbidities, the most common being anxiety/depressive disorders, OCD, PTSD, and ADHD. This study suggests Trichotillomania is relatively common in the general population and typically characterized by moderate-high distress and high rates of comorbidity.
-
duration of illness and cortical thickness in Trichotillomania preliminary evidence for illness change over time
European Neuropsychopharmacology, 2020Co-Authors: Jon E Grant, Dan J. Stein, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a psychiatric condition characterized by repetitive pulling out of one's hair, leading to marked functional impairment. The aim of this study was to examine the association between duration of Trichotillomania (defined as time between initial age of onset and current age) and structural brain abnormalities by pooling all available global data. Authors of published neuroimaging studies of Trichotillomania were contacted and invited to contribute de-identified MRI scans for a pooled analysis. Freesurfer pipelines were used to examine whether cortical thickness and sub-cortical volumes were associated with duration of illness in adults with Trichotillomania. The sample comprised 50 adults with Trichotillomania (100% not taking psychotropic medication; mean [SD] age 34.3 [12.3] years; 92% female). Longer duration of illness was associated with lower cortical thickness in bilateral superior frontal cortex and left rostral middle frontal cortex. Volumes of the a priori sub-cortical structures of interest were not significantly correlated with duration of illness (all p > 0.05 uncorrected). This study is the first to suggest that Trichotillomania is associated with biological changes over time. If this finding is supported by prospective studies, it could have important implications for treatment (i.e. treatment might need to be tailored for stage of illness). Viewed alongside prior work, the data suggest that brain changes in Trichotillomania may be differentially associated with vulnerability (excess thickness in right inferior frontal cortex) and with chronicity (reduced thickness in medial and superior frontal cortex). Longitudinal research is now indicated.
-
Trichotillomania (hair pulling disorder).
Indian journal of psychiatry, 2019Co-Authors: Jon E GrantAbstract:Trichotillomania is characterized by the repetitive pulling out of one's own hair leading to hair loss and possibly functional impairment. Trichotillomania has been documented in the medical literature since the 19th century. Prevalence studies suggest that Trichotillomania is a common disorder (point prevalence estimates of 0.5%-2.0%). Although grouped with the obsessive-compulsive disorder (OCD) in the diagnostic and statistical manual of mental disorders-5, Trichotillomania is distinct from OCD in many respects. For example, the treatment of Trichotillomania generally employs habit reversal therapy and medication (n-acetylcysteine or olanzapine), both of which are quite different from those used to treat OCD. Conversely, some first-line treatments used for OCD (e.g., selective serotonin reuptake inhibitors) appear ineffective for Trichotillomania. This article presents what is known about Trichotillomania and the evidence for a variety of treatment interventions.
-
salivary sex hormones in adolescent females with Trichotillomania
Psychiatry Research-neuroimaging, 2018Co-Authors: Jon E Grant, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is several times more common in women and has peak onset around puberty. The role of sex hormones, however, has received little research. 11 adolescent girls with Trichotillomania, post-menarche and not taking birth control, were examined on a variety of clinical measures. Participants provided saliva samples for analysis of estradiol, progesterone, and testosterone levels. Lower progesterone was associated with more severe symptoms and lower levels of all hormones were associated with worse overall functioning. Adolescents with Trichotillomania exhibit a range of hormone levels but that lower levels of certain hormones may have important clinical associations.
-
Striatal abnormalities in Trichotillomania: a multi-site MRI analysis.
NeuroImage. Clinical, 2017Co-Authors: Masanori Isobe, Dan J. Stein, Jon E Grant, Sarah A. Redden, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Trichotillomania (hair-pulling disorder) is characterized by the repetitive pulling out of one's own hair, and is classified as an Obsessive-Compulsive Related Disorder. Abnormalities of the ventral and dorsal striatum have been implicated in disease models of Trichotillomania, based on translational research, but direct evidence is lacking. The aim of this study was to elucidate subcortical morphometric abnormalities, including localized curvature changes, in Trichotillomania. De-identified MRI scans were pooled by contacting authors of previous peer-reviewed studies that examined brain structure in adult patients with Trichotillomania, following an extensive literature search. Group differences on subcortical volumes of interest were explored (t-tests) and localized differences in subcortical structure morphology were quantified using permutation testing. The pooled sample comprised N=68 individuals with Trichotillomania and N=41 healthy controls. Groups were well-matched in terms of age, gender, and educational levels. Significant volumetric reductions were found in Trichotillomania patients versus controls in right amygdala and left putamen. Localized shape deformities were found in bilateral nucleus accumbens, bilateral amygdala, right caudate and right putamen. Structural abnormalities of subcortical regions involved in affect regulation, inhibitory control, and habit generation, play a key role in the pathophysiology of Trichotillomania. Trichotillomania may constitute a useful model through which to better understand other compulsive symptoms. These findings may account for why certain medications appear effective for Trichotillomania, namely those modulating subcortical dopamine and glutamatergic function. Future work should study the state versus trait nature of these changes, and the impact of treatment.
Samuel R. Chamberlain - One of the best experts on this subject based on the ideXlab platform.
-
Prevalence, gender correlates, and co-morbidity of Trichotillomania
Psychiatry research, 2020Co-Authors: Jon E Grant, Darin D. Dougherty, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a mental health condition characterized by repetitive pulling out of one's hair, often leading to functional impairment and/or distress. A convenience sampling of 10,169 adults, aged 18–69 years, representative of the general US population, completed a survey to establish occurrence of Trichotillomania, other mental health concerns, and impact of the illness. 175 (1.7%) identified as having current Trichotillomania. Rates of Trichotillomania did not differ significantly based on gender (1.8% of males and 1.7% of females). The mean age of onset for Trichotillomania was 17.7 years. The mean age of onset differed significantly for males (mean 19.0 years) versus females (mean 14.8 years (p = 0.020). The average amount of distress reported due to Trichotillomania was relatively high, and 79% of people with Trichotillomania had one or more mental health comorbidities, the most common being anxiety/depressive disorders, OCD, PTSD, and ADHD. This study suggests Trichotillomania is relatively common in the general population and typically characterized by moderate-high distress and high rates of comorbidity.
-
duration of illness and cortical thickness in Trichotillomania preliminary evidence for illness change over time
European Neuropsychopharmacology, 2020Co-Authors: Jon E Grant, Dan J. Stein, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a psychiatric condition characterized by repetitive pulling out of one's hair, leading to marked functional impairment. The aim of this study was to examine the association between duration of Trichotillomania (defined as time between initial age of onset and current age) and structural brain abnormalities by pooling all available global data. Authors of published neuroimaging studies of Trichotillomania were contacted and invited to contribute de-identified MRI scans for a pooled analysis. Freesurfer pipelines were used to examine whether cortical thickness and sub-cortical volumes were associated with duration of illness in adults with Trichotillomania. The sample comprised 50 adults with Trichotillomania (100% not taking psychotropic medication; mean [SD] age 34.3 [12.3] years; 92% female). Longer duration of illness was associated with lower cortical thickness in bilateral superior frontal cortex and left rostral middle frontal cortex. Volumes of the a priori sub-cortical structures of interest were not significantly correlated with duration of illness (all p > 0.05 uncorrected). This study is the first to suggest that Trichotillomania is associated with biological changes over time. If this finding is supported by prospective studies, it could have important implications for treatment (i.e. treatment might need to be tailored for stage of illness). Viewed alongside prior work, the data suggest that brain changes in Trichotillomania may be differentially associated with vulnerability (excess thickness in right inferior frontal cortex) and with chronicity (reduced thickness in medial and superior frontal cortex). Longitudinal research is now indicated.
-
salivary sex hormones in adolescent females with Trichotillomania
Psychiatry Research-neuroimaging, 2018Co-Authors: Jon E Grant, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is several times more common in women and has peak onset around puberty. The role of sex hormones, however, has received little research. 11 adolescent girls with Trichotillomania, post-menarche and not taking birth control, were examined on a variety of clinical measures. Participants provided saliva samples for analysis of estradiol, progesterone, and testosterone levels. Lower progesterone was associated with more severe symptoms and lower levels of all hormones were associated with worse overall functioning. Adolescents with Trichotillomania exhibit a range of hormone levels but that lower levels of certain hormones may have important clinical associations.
-
Striatal abnormalities in Trichotillomania: a multi-site MRI analysis.
NeuroImage. Clinical, 2017Co-Authors: Masanori Isobe, Dan J. Stein, Jon E Grant, Sarah A. Redden, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Trichotillomania (hair-pulling disorder) is characterized by the repetitive pulling out of one's own hair, and is classified as an Obsessive-Compulsive Related Disorder. Abnormalities of the ventral and dorsal striatum have been implicated in disease models of Trichotillomania, based on translational research, but direct evidence is lacking. The aim of this study was to elucidate subcortical morphometric abnormalities, including localized curvature changes, in Trichotillomania. De-identified MRI scans were pooled by contacting authors of previous peer-reviewed studies that examined brain structure in adult patients with Trichotillomania, following an extensive literature search. Group differences on subcortical volumes of interest were explored (t-tests) and localized differences in subcortical structure morphology were quantified using permutation testing. The pooled sample comprised N=68 individuals with Trichotillomania and N=41 healthy controls. Groups were well-matched in terms of age, gender, and educational levels. Significant volumetric reductions were found in Trichotillomania patients versus controls in right amygdala and left putamen. Localized shape deformities were found in bilateral nucleus accumbens, bilateral amygdala, right caudate and right putamen. Structural abnormalities of subcortical regions involved in affect regulation, inhibitory control, and habit generation, play a key role in the pathophysiology of Trichotillomania. Trichotillomania may constitute a useful model through which to better understand other compulsive symptoms. These findings may account for why certain medications appear effective for Trichotillomania, namely those modulating subcortical dopamine and glutamatergic function. Future work should study the state versus trait nature of these changes, and the impact of treatment.
-
Trichotillomania and co-occurring anxiety
Comprehensive psychiatry, 2016Co-Authors: Jon E Grant, Sarah A. Redden, Eric W. Leppink, Samuel R. ChamberlainAbstract:Abstract Background Trichotillomania appears to be a fairly common disorder, with high rates of co-occurring anxiety disorders. Many individuals with Trichotillomania also report that pulling worsens during periods of increased anxiety. Even with these clinical links to anxiety, little research has explored whether Trichotillomania with co-occurring anxiety is a meaningful subtype. Methods One hundred sixty-five adults with Trichotillomania were examined on a variety of clinical measures including symptom severity, functioning, and comorbidity. Participants also underwent cognitive testing assessing motor inhibition and cognitive flexibility. Clinical features and cognitive functioning were compared between those with current co-occurring anxiety disorders (i.e. social anxiety, generalized anxiety disorder, panic disorder, and anxiety disorder NOS) (n=38) and those with no anxiety disorder (n=127). Results Participants with Trichotillomania and co-occurring anxiety reported significantly worse hair pulling symptoms, were more likely to have co-occurring depression, and were more likely to have a first-degree relative with obsessive compulsive disorder. Those with anxiety disorders also exhibited significantly worse motor inhibitory performance on a task of motor inhibition (stop-signal task). Conclusions This study suggests that anxiety disorders affect the clinical presentation of hair pulling behavior. Further research is needed to validate our findings and to consider whether treatments should be specially tailored differently for adults with Trichotillomania who have co-occurring anxiety disorders, or more pronounced cognitive impairment.
Dan J. Stein - One of the best experts on this subject based on the ideXlab platform.
-
duration of illness and cortical thickness in Trichotillomania preliminary evidence for illness change over time
European Neuropsychopharmacology, 2020Co-Authors: Jon E Grant, Dan J. Stein, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a psychiatric condition characterized by repetitive pulling out of one's hair, leading to marked functional impairment. The aim of this study was to examine the association between duration of Trichotillomania (defined as time between initial age of onset and current age) and structural brain abnormalities by pooling all available global data. Authors of published neuroimaging studies of Trichotillomania were contacted and invited to contribute de-identified MRI scans for a pooled analysis. Freesurfer pipelines were used to examine whether cortical thickness and sub-cortical volumes were associated with duration of illness in adults with Trichotillomania. The sample comprised 50 adults with Trichotillomania (100% not taking psychotropic medication; mean [SD] age 34.3 [12.3] years; 92% female). Longer duration of illness was associated with lower cortical thickness in bilateral superior frontal cortex and left rostral middle frontal cortex. Volumes of the a priori sub-cortical structures of interest were not significantly correlated with duration of illness (all p > 0.05 uncorrected). This study is the first to suggest that Trichotillomania is associated with biological changes over time. If this finding is supported by prospective studies, it could have important implications for treatment (i.e. treatment might need to be tailored for stage of illness). Viewed alongside prior work, the data suggest that brain changes in Trichotillomania may be differentially associated with vulnerability (excess thickness in right inferior frontal cortex) and with chronicity (reduced thickness in medial and superior frontal cortex). Longitudinal research is now indicated.
-
Striatal abnormalities in Trichotillomania: a multi-site MRI analysis.
NeuroImage. Clinical, 2017Co-Authors: Masanori Isobe, Dan J. Stein, Jon E Grant, Sarah A. Redden, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Trichotillomania (hair-pulling disorder) is characterized by the repetitive pulling out of one's own hair, and is classified as an Obsessive-Compulsive Related Disorder. Abnormalities of the ventral and dorsal striatum have been implicated in disease models of Trichotillomania, based on translational research, but direct evidence is lacking. The aim of this study was to elucidate subcortical morphometric abnormalities, including localized curvature changes, in Trichotillomania. De-identified MRI scans were pooled by contacting authors of previous peer-reviewed studies that examined brain structure in adult patients with Trichotillomania, following an extensive literature search. Group differences on subcortical volumes of interest were explored (t-tests) and localized differences in subcortical structure morphology were quantified using permutation testing. The pooled sample comprised N=68 individuals with Trichotillomania and N=41 healthy controls. Groups were well-matched in terms of age, gender, and educational levels. Significant volumetric reductions were found in Trichotillomania patients versus controls in right amygdala and left putamen. Localized shape deformities were found in bilateral nucleus accumbens, bilateral amygdala, right caudate and right putamen. Structural abnormalities of subcortical regions involved in affect regulation, inhibitory control, and habit generation, play a key role in the pathophysiology of Trichotillomania. Trichotillomania may constitute a useful model through which to better understand other compulsive symptoms. These findings may account for why certain medications appear effective for Trichotillomania, namely those modulating subcortical dopamine and glutamatergic function. Future work should study the state versus trait nature of these changes, and the impact of treatment.
-
skin picking and Trichotillomania in adults with obsessive compulsive disorder
Comprehensive Psychiatry, 2012Co-Authors: Lucas Lovato, Dan J. Stein, Ygor Arzeno Ferrao, Roseli Gedanke Shavitt, Leonardo F Fontenelle, Analise Vivan, Euripedes Constantino Miguel, Aristides Volpato CordioliAbstract:The objective of this study was to compare patients with obsessive-compulsive disorder (OCD) associated with pathologic skin picking (PSP) and/or Trichotillomania, and patients with OCD without such comorbidities, for demographic and clinical characteristics. We assessed 901 individuals with a primary diagnosis of OCD, using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I disorders. Diagnoses of PSP and Trichotillomania were made in 16.3% and 4.9% of the sample, respectively. After the logistic regression analysis, the following factors retained an association with OCD-PSP/Trichotillomania: younger (odds ratio [OR] = 0.979; P = .047), younger at the onset of compulsive symptoms (OR = 0.941; P = .007), woman (OR = 2.538; P < .001), with a higher level of education (OR = 1.055; P = .025), and with comorbid body dysmorphic disorder (OR = 2.363; P = .004). These findings support the idea that OCD accompanied by PSP/Trichotillomania characterizes a specific subgroup.
-
Trichotillomania and skin‐picking: A phenomenological comparison
Depression and anxiety, 2002Co-Authors: Christine Lochner, Daphne Simeon, Dana J.h. Niehaus, Dan J. SteinAbstract:Although Trichotillomania and pathological skin-picking are both characterized by repetitive self-injurious stereotypic behaviors, the former is classified as an impulse control disorder, while the latter is not given a specific diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) [APA, 1994]. There are, however, few empirical data on phenomenological similarities and differences between these disorders. Patients with Trichotillomania and pathological skin-picking were compared in terms of several demographic (age, gender), clinical (comorbid axis I and II disorders), and personality variables. Trichotillomania and pathological skin-picking were very similar in demographics, psychiatric comorbidity, and personality dimensions. Dissociative symptoms may be more common in Trichotillomania than in pathological skin-picking. These data support the concept of phenomenological overlap between Trichotillomania and pathological skin-picking. Future work to assess the implications of overlap for clinical evaluation and intervention in the two conditions may be useful.
-
Trichotillomania and skin picking a phenomenological comparison
Depression and Anxiety, 2002Co-Authors: Christine Lochner, Daphne Simeon, Dana J.h. Niehaus, Dan J. SteinAbstract:Although Trichotillomania and pathological skin-picking are both characterized by repetitive self-injurious stereotypic behaviors, the former is classified as an impulse control disorder, while the latter is not given a specific diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) [APA, 1994]. There are, however, few empirical data on phenomenological similarities and differences between these disorders. Patients with Trichotillomania and pathological skin-picking were compared in terms of several demographic (age, gender), clinical (comorbid axis I and II disorders), and personality variables. Trichotillomania and pathological skin-picking were very similar in demographics, psychiatric comorbidity, and personality dimensions. Dissociative symptoms may be more common in Trichotillomania than in pathological skin-picking. These data support the concept of phenomenological overlap between Trichotillomania and pathological skin-picking. Future work to assess the implications of overlap for clinical evaluation and intervention in the two conditions may be useful.
Christine Lochner - One of the best experts on this subject based on the ideXlab platform.
-
duration of illness and cortical thickness in Trichotillomania preliminary evidence for illness change over time
European Neuropsychopharmacology, 2020Co-Authors: Jon E Grant, Dan J. Stein, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Abstract Trichotillomania is a psychiatric condition characterized by repetitive pulling out of one's hair, leading to marked functional impairment. The aim of this study was to examine the association between duration of Trichotillomania (defined as time between initial age of onset and current age) and structural brain abnormalities by pooling all available global data. Authors of published neuroimaging studies of Trichotillomania were contacted and invited to contribute de-identified MRI scans for a pooled analysis. Freesurfer pipelines were used to examine whether cortical thickness and sub-cortical volumes were associated with duration of illness in adults with Trichotillomania. The sample comprised 50 adults with Trichotillomania (100% not taking psychotropic medication; mean [SD] age 34.3 [12.3] years; 92% female). Longer duration of illness was associated with lower cortical thickness in bilateral superior frontal cortex and left rostral middle frontal cortex. Volumes of the a priori sub-cortical structures of interest were not significantly correlated with duration of illness (all p > 0.05 uncorrected). This study is the first to suggest that Trichotillomania is associated with biological changes over time. If this finding is supported by prospective studies, it could have important implications for treatment (i.e. treatment might need to be tailored for stage of illness). Viewed alongside prior work, the data suggest that brain changes in Trichotillomania may be differentially associated with vulnerability (excess thickness in right inferior frontal cortex) and with chronicity (reduced thickness in medial and superior frontal cortex). Longitudinal research is now indicated.
-
Striatal abnormalities in Trichotillomania: a multi-site MRI analysis.
NeuroImage. Clinical, 2017Co-Authors: Masanori Isobe, Dan J. Stein, Jon E Grant, Sarah A. Redden, Nancy J. Keuthen, Christine Lochner, Samuel R. ChamberlainAbstract:Trichotillomania (hair-pulling disorder) is characterized by the repetitive pulling out of one's own hair, and is classified as an Obsessive-Compulsive Related Disorder. Abnormalities of the ventral and dorsal striatum have been implicated in disease models of Trichotillomania, based on translational research, but direct evidence is lacking. The aim of this study was to elucidate subcortical morphometric abnormalities, including localized curvature changes, in Trichotillomania. De-identified MRI scans were pooled by contacting authors of previous peer-reviewed studies that examined brain structure in adult patients with Trichotillomania, following an extensive literature search. Group differences on subcortical volumes of interest were explored (t-tests) and localized differences in subcortical structure morphology were quantified using permutation testing. The pooled sample comprised N=68 individuals with Trichotillomania and N=41 healthy controls. Groups were well-matched in terms of age, gender, and educational levels. Significant volumetric reductions were found in Trichotillomania patients versus controls in right amygdala and left putamen. Localized shape deformities were found in bilateral nucleus accumbens, bilateral amygdala, right caudate and right putamen. Structural abnormalities of subcortical regions involved in affect regulation, inhibitory control, and habit generation, play a key role in the pathophysiology of Trichotillomania. Trichotillomania may constitute a useful model through which to better understand other compulsive symptoms. These findings may account for why certain medications appear effective for Trichotillomania, namely those modulating subcortical dopamine and glutamatergic function. Future work should study the state versus trait nature of these changes, and the impact of treatment.
-
Trichotillomania and skin‐picking: A phenomenological comparison
Depression and anxiety, 2002Co-Authors: Christine Lochner, Daphne Simeon, Dana J.h. Niehaus, Dan J. SteinAbstract:Although Trichotillomania and pathological skin-picking are both characterized by repetitive self-injurious stereotypic behaviors, the former is classified as an impulse control disorder, while the latter is not given a specific diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) [APA, 1994]. There are, however, few empirical data on phenomenological similarities and differences between these disorders. Patients with Trichotillomania and pathological skin-picking were compared in terms of several demographic (age, gender), clinical (comorbid axis I and II disorders), and personality variables. Trichotillomania and pathological skin-picking were very similar in demographics, psychiatric comorbidity, and personality dimensions. Dissociative symptoms may be more common in Trichotillomania than in pathological skin-picking. These data support the concept of phenomenological overlap between Trichotillomania and pathological skin-picking. Future work to assess the implications of overlap for clinical evaluation and intervention in the two conditions may be useful.
-
Trichotillomania and skin picking a phenomenological comparison
Depression and Anxiety, 2002Co-Authors: Christine Lochner, Daphne Simeon, Dana J.h. Niehaus, Dan J. SteinAbstract:Although Trichotillomania and pathological skin-picking are both characterized by repetitive self-injurious stereotypic behaviors, the former is classified as an impulse control disorder, while the latter is not given a specific diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) [APA, 1994]. There are, however, few empirical data on phenomenological similarities and differences between these disorders. Patients with Trichotillomania and pathological skin-picking were compared in terms of several demographic (age, gender), clinical (comorbid axis I and II disorders), and personality variables. Trichotillomania and pathological skin-picking were very similar in demographics, psychiatric comorbidity, and personality dimensions. Dissociative symptoms may be more common in Trichotillomania than in pathological skin-picking. These data support the concept of phenomenological overlap between Trichotillomania and pathological skin-picking. Future work to assess the implications of overlap for clinical evaluation and intervention in the two conditions may be useful.
Brian L. Odlaug - One of the best experts on this subject based on the ideXlab platform.
-
The endocannabinoid system and Trichotillomania: A promising target for treatment?
Cannabinoids in Neurologic and Mental Disease, 2015Co-Authors: Jon E Grant, Brian L. Odlaug, Samuel R. ChamberlainAbstract:Trichotillomania is characterized by the repetitive pulling out of one’s hair leading to hair loss and functional impairment. Understanding the pathophysiology of Trichotillomania is one approach to the eventual development of more effective treatment options for this disorder. The current body of neuroscience research in Trichotillomania is limited, but the available evidence of disorders arguably related to Trichotillomania (for example, Tourette’s syndrome and obsessive-compulsive disorder) offers hints of possible mechanisms underlying repetitive motor behaviors. Preliminary research supports the possible use of Δ 9 -tetrahydro-cannabinol in the reduction of tics and obsessive-compulsive symptoms. In addition, in an open-label pharmacotherapy study a cannabinoid agonist was effective in reducing hair pulling behavior in Trichotillomania. Taken together, these findings suggest that pharmacological modulation of the endocannabinoid system may be a promising avenue to help reduce the compulsive motoric aspect of Trichotillomania.
-
Diagnosis and treatment of Trichotillomania
Neuropsychiatry, 2011Co-Authors: Liana Rn Schreiber, Brian L. Odlaug, Jon E GrantAbstract:Trichotillomania is characterized by repetitive hair pulling resulting in significant hair loss, distress, and social and/or occupational impairment. Co-occurring disorders are common among those with Trichotillomania. Stress, emotional dysregulation, positive and negative reinforcement, and genetics have been explored as factors in the etiology of the disorder. Furthermore, animal models have been developed for investigating the possible development of Trichotillomania, while brain imaging studies have provided evidence that several brain regions may be involved in Trichotillomania. Psychological and pharmacological treatment data are incomplete, but behavioral therapy, NâÂÂacetyl cysteine and olanzapine may be helpful for individuals with Trichotillomania.
-
reduced brain white matter integrity in Trichotillomania a diffusion tensor imaging study
Archives of General Psychiatry, 2010Co-Authors: Samuel R. Chamberlain, Jon E Grant, Brian L. Odlaug, Naomi A Fineberg, Adam Hampshire, Lara Menzies, Eleftherios Garyfallidis, Kevin J Craig, Barbara J SahakianAbstract:Context Trichotillomania is an Axis I disorder characterized by repetitive, pathological hair pulling. Objective To assess the integrity of white matter tracts in subjects with the disorder. Design Between-group comparison using permutation cluster analysis, with stringent correction for multiple comparisons. Setting Academic psychiatry department. Participants Eighteen volunteers meeting DSM-IV criteria for Trichotillomania and 19 healthy control subjects. Main Outcome Measures Fractional anisotropy (measured using diffusion tensor imaging), Trichotillomania disease severity (Massachusetts General Hospital Hairpulling Scale score), and dysphoria (Montgomery-Asberg Depression Rating Scale score). Results Subjects with Trichotillomania exhibited significantly reduced fractional anisotropy in anterior cingulate, presupplementary motor area, and temporal cortices. Fractional anisotropy did not correlate significantly with Trichotillomania disease severity or depressive mood scores. Conclusions These data implicate disorganization of white matter tracts involved in motor habit generation and suppression, along with affective regulation, in the pathophysiology of Trichotillomania.
-
n acetylcysteine a glutamate modulator in the treatment of Trichotillomania a double blind placebo controlled study
Archives of General Psychiatry, 2009Co-Authors: Jon E Grant, Brian L. OdlaugAbstract:Context: Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of Trichotillomania are limited to conflicting studies of serotonergic medications. N-acetylcysteine, an amino acid, seems to restore the extracellular glutamate concentration in the nucleus accumbens and, therefore, offers promise in the reduction of compulsive behavior. Objective: To determine the efficacy and tolerability of N-acetylcysteine in adults with Trichotillomania. Design: Twelve-week, double-blind, placebo-controlled trial. Setting: Ambulatory care center. Patients: Fifty individuals with Trichotillomania (45 women and 5 men; mean [SD] age, 34.3 [12.1] years). Interventions: N-acetylcysteine (dosing range, 1200-2400 mg/d) or placebo was administered for 12 weeks. Main outcome measures: Patients were assessed using the Massachusetts General Hospital Hair Pulling Scale, the Clinical Global Impression scale, the Psychiatric Institute Trichotillomania Scale, and measures of depression, anxiety, and psychosocial functioning. Outcomes were examined using analysis of variance modeling analyses and linear regression in an intention-to-treat population. Results: Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale (P < .001) and the Psychiatric Institute Trichotillomania Scale (P = .001). Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16% taking placebo (P = .003). Significant improvement was initially noted after 9 weeks of treatment. Conclusions: This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of Trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in Trichotillomania symptoms. No adverse events occurred in the N-acetylcysteine group, and N-acetylcysteine was well tolerated. Pharmacologic modulation of the glutamate system may prove to be useful in the control of a range of compulsive behaviors. Trial registration: clinicaltrials.gov Identifier: NCT00354770.
-
Trichotillomania: neurobiology and treatment.
Neuroscience and biobehavioral reviews, 2009Co-Authors: Samuel R. Chamberlain, Brian L. Odlaug, Naomi A Fineberg, Vasileios Boulougouris, Jon E GrantAbstract:Trichotillomania is a disorder characterized by repetitive hair pulling, leading to noticeable hair loss and functional impairment. This paper provides an overview of what is known of Trichotillomania from several perspectives. We begin by considering historical descriptions of hair pulling that ultimately contributed to the inclusion of Trichotillomania as a formal diagnostic entity in the Diagnostic and Statistical Manual. Psychological factors involved in the mediation of symptoms are examined, including positive and negative reinforcement. The relationships between Trichotillomania, other body-focused repetitive behaviours, and disorders of the putative obsessive-compulsive (OC) spectrum are surveyed. The review then explores findings from the available controlled treatment trials that utilized psychotherapy, pharmacotherapy, or both. Neural circuitry involved in the manifestation of hair pulling is then identified by considering data from animal models of the condition, along with neurocognitive and neuroimaging results from patients. Finally, we highlight important areas for future neurobiological and treatment research.
