Trichotillomania

Gary Christenson

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Trichotillomania denotes the pulling out of one's own hair. Trichocryptomania refers to breaking off the hair and can be conceptualized as a similar condition. Definition

Both DSM-IV(!) and ICD-10(2) define trichotillomania similarly. Recurrent pulling out of one's hair must result in noticeable hair loss. An increasing sense of tension is experienced before hair pulling (or when attempting to resist the behaviour according to DSM-IV) and pleasure, gratification, or relief results from pulling out hair. Hair pulling should not be better accounted for by another mental disorder or be due to a dermatological or other medical condition. DSM-IV requires that the disturbance causes clinically significant distress or impairment in functioning.

Not all patients, particularly children, report mounting tension, tension reduction, or gratification when pulling out hair. (3) Additionally, a patient may have a completely denuded scalp yet deny much stress or impaired functioning. Therefore the term trichotillomania is typically used to refer to the minimum criteria of visible hair loss secondary to hair pulling, which is not attributable to psychotic thinking or a medical condition.

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