Trichotillomania as a Manifestation of Dementia

Pathological hair-pulling or trichotillomania, which is commonly associated with anxiety and depression, obsessive-compulsive disorder, and neurodevelopmental disorders, has been rarely associated with dementing illnesses. Investigators have not clarified the neural correlates and treatment of trich...

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Main Authors: Pongsatorn Paholpak, Mario F. Mendez
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2016/9782702
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author Pongsatorn Paholpak
Mario F. Mendez
author_facet Pongsatorn Paholpak
Mario F. Mendez
author_sort Pongsatorn Paholpak
collection DOAJ
description Pathological hair-pulling or trichotillomania, which is commonly associated with anxiety and depression, obsessive-compulsive disorder, and neurodevelopmental disorders, has been rarely associated with dementing illnesses. Investigators have not clarified the neural correlates and treatment of trichotillomania in dementia. We report a patient who developed an early-onset cognitive decline with genetic, cerebrospinal fluid biomarker and structural and functional neuroimaging studies consistent with Alzheimer’s disease. Eight years into her disease, she developed severe, repetitive hair-pulling behavior leading to marked hair loss, along with other repetitive and “frontal” behaviors. Selective serotonin reuptake inhibitors (SSRIs) were ineffective in controlling her hair-pulling behavior, which subsequently responded to quetiapine 150 mg/day. This patient and a review of the literature suggest that trichotillomania may be a compulsive-related symptom in dementias of different etiologies as they involve frontal areas and release primitive grooming behavior from frontostriatal dysfunction. Dopamine blockade, rather than SSRIs, may be effective in managing trichotillomania in dementia.
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spelling doaj-art-c155c09bb8cc462fa07f494527a017cc2025-08-20T03:23:28ZengWileyCase Reports in Psychiatry2090-682X2090-68382016-01-01201610.1155/2016/97827029782702Trichotillomania as a Manifestation of DementiaPongsatorn Paholpak0Mario F. Mendez1Department of Neurology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USADepartment of Neurology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USAPathological hair-pulling or trichotillomania, which is commonly associated with anxiety and depression, obsessive-compulsive disorder, and neurodevelopmental disorders, has been rarely associated with dementing illnesses. Investigators have not clarified the neural correlates and treatment of trichotillomania in dementia. We report a patient who developed an early-onset cognitive decline with genetic, cerebrospinal fluid biomarker and structural and functional neuroimaging studies consistent with Alzheimer’s disease. Eight years into her disease, she developed severe, repetitive hair-pulling behavior leading to marked hair loss, along with other repetitive and “frontal” behaviors. Selective serotonin reuptake inhibitors (SSRIs) were ineffective in controlling her hair-pulling behavior, which subsequently responded to quetiapine 150 mg/day. This patient and a review of the literature suggest that trichotillomania may be a compulsive-related symptom in dementias of different etiologies as they involve frontal areas and release primitive grooming behavior from frontostriatal dysfunction. Dopamine blockade, rather than SSRIs, may be effective in managing trichotillomania in dementia.http://dx.doi.org/10.1155/2016/9782702
spellingShingle Pongsatorn Paholpak
Mario F. Mendez
Trichotillomania as a Manifestation of Dementia
Case Reports in Psychiatry
title Trichotillomania as a Manifestation of Dementia
title_full Trichotillomania as a Manifestation of Dementia
title_fullStr Trichotillomania as a Manifestation of Dementia
title_full_unstemmed Trichotillomania as a Manifestation of Dementia
title_short Trichotillomania as a Manifestation of Dementia
title_sort trichotillomania as a manifestation of dementia
url http://dx.doi.org/10.1155/2016/9782702
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