Tricotilomania: [revisão] / Trichotillomania: [review]

CONTEXTO: Relatada desde a Antiguidade, a tricotilomania (TTM) somente na última década despertou maior interesse clínico, sendo incluída no DSM-IV-TR (The Diagnostic and Statistical Manual of Mental Disorders 4th Text Revision) como um transtorno do controle dos impulsos não especificado. Dados recentes estimam uma prevalência em torno de 3 por cento, indicando uma incidência mais comum do que se imaginava. Aspectos clínicos e terapêuticos ainda não estão totalmente definidos. OBJETIVO: Revisão sistemática da literatura de vários aspectos da tricotilomania pertinentes à teoria clínica e prática. MÉTODO: Os termos "trichotillomania", "epidemiology", "clinical characteristics", "etiology", "comorbidity" e "treatment" foram consultados nas bases de dados Medline/PubMed, Lilacs, PsycINFO e Cochrane Library. RESULTADOS: Pesquisas com populações não clínicas sugerem que a TTM é mais comum do que se acreditava. Aspectos fenomenológicos, taxonômicos, comorbidades e possibilidades terapêuticas são discutidos. CONCLUSÃO: Apesar de um crescente número de estudos recentes, questões clínicas e terapêuticas permanecem em aberto. Com base nesta revisão da literatura, sugerem-se direções para diagnóstico, tratamento e futuras pesquisas.

BACKGROUND: Recognized since antiquity, only within the last decade has the subject of trichotillomania provoked any larger clinical interest since it has been included in the DSM-IV-TR (The Diagnostic and Statistical Manual of Mental Disorders 4th Text Revision) as a disturbance of the impulse-control disorders not elsewhere classified. Recent data estimates its prevalence at around 3 percent. Although more common than it was imagined before, clinical and therapeutic aspects are still not well defined. OBJECTIVE: Systematic revision in the literature of several aspects of trichotillomania and its clinical and practical theory. METHOD: The term "trichotillomania", "its epidemiology", "clinical characteristics", "etiology", "comorbidity" and "treatment" were searched in the data bases of Medline/ PubMed, Lilacs, PsycINFO and Cochrane Library. RESULTS: Research with no clinical populations suggests that TTM is more common than it was previously suspected. Phenomenological and taxonomical aspects, comorbidity as well as therapeutic possibilities are discussed. CONCLUSION: Despite a growing number of recent studies, clinical and therapeutic aspects remain undefined. Based on this literature's review, directions are suggested concerning diagnosis, treatment and future research.

Tricotilomania / Trichotillomania

A tricotilomania é caracterizada por alopecia, resultante de hábito repetitivo de puxar o cabelo exercido pelo próprio paciente. Além do comprometimento estético e conseqüências sociais, o hábito pode levar a complicações. O artigo procura familiarizar o leitor com os principais aspectos clínicos e o tratamento a ser utilizado nos casos de tricotilomania, com ênfase nas técnicas de terapia comportamental.

Trichotillomania is characterized by hair loss from a patient's repetitive self-pulling of hair. This habit is embarrassing, unattractive, socially undesirable, and can predispose to some complications. The purpose of this article is to familiarize the reader with clinical features of trichotillomania and to describe appropriate therapeutic approach to be applied, with particular attention to behavior therapy techniques.

Trichotillomania in children.

In this paper, we describe the sociodemographic profile, clinical characteristics and treatment outcome of 20 children with trichotillomania. These children presented to the Child Adolescent Psychiatry Clinic over a period of 6 years, with a prevalence of 1.24% . Most subjects were females (85%), hindu by religion (65%), and belonged to urban nuclear family (70%). The mean age at first presentation was 10.1 yr (SD = 4.4). Comorbid psychiatric illness and family history of psychiatric disorders was present in 40% and 20% cases, respectively. Nearly two-third of these had associated impulse; 75% denied resistance to pluck. Children who continued treatment, showed improvement.

Pattern of skin disorders in Muzaffarabad: a comparison of pre- and post-earthquake scenario

Psyche and skin are closely related. The anatomical and physiological integrity is maintained when they are congruent in their functioning. Natural calamities and disasters affect this harmony adversely by causing psychological as well as physical trauma, which leads to a number of immediate as well as long term skin ailments. The study was aimed to observe any change in pattern of skin diseases in Muzaffarabad after devastating earthquake of October 8th, 2005. Patients and methods The study was carried out in CMH, Muzaffarabad from March, 2006 to August 2006. Patient's record of same six months of last year was retrieved and was compared with present record. Patients of all ages, with any cutaneous disease, attending the outpatient departments or admitted to the skin ward of Combined Military Hospital Muzaffarabad, from 1St March 2006 to 31St August 2006, were included in the study. A detailed dermatological evaluation was carried out in all patients. Relevant investigations like o scraping for fungus and biopsy were done when required. Indoor as well as outpatients' record for the same period of last year [2005] was retrieved. The information were duly documented and compiled. Prevalence of various common skin disorders was compared in pre and post earthquake scenario and statistical evaluation was done by calculating p-value after applying z-test. In post-earthquake period, overall proportion of skin patients increased when compared with similar per-earthquake period. Infections remained at the top in both scenarios but their proportion increased significantly after earthquake period. Psychocutaneous disorders like, trichotillothania and dermatitis artifacta were also frequently seen in post- earthquake period. Hair, nail, pigmentary disorders, sexually transmitted infections were statistically less frequent in post earthquake period. Eczemas, psoriasis and vitiligo were also less frequently reported. A significant increase in overall proportion of skin patients and prevalence of bacterial infections, viral infections, scabies and certain psychocutaneous disorders was probably related to compromised hygiene and sanitation and psychological trauma as consequence of devastating earthquake of October 8th, 2005

Trastornos del control de impulsos / Impulse control disorders

Se revisan las patologías incluidas en este grupo de trastornos, sus antecedentes históricos y principales teorías etiológicas. Se destacan los aspectos forenses y se incluyen algunos antecedentes nacionales

Tricotilomania: relato de um caso clínico / Trichotillomania: relate of a clinical case

É a tricotilomania um impulso irresistível de arrancar os cabelos. Tal estudo consiste de relato sobre um caso clínico de um paciente portador de tricotilomania, com uma abordagem teórica e conclusöes acerca do assunto