Double Jeopardy - A Case Of Trichotillomania And Intellectual Disability
- Author:
Sutapa Basu
- Publication Type:Case Reports
- Keywords:
Intellectual disability;
Trichotillomania;
Trichophagia
- From:ASEAN Journal of Psychiatry
2015;16(2):1-5
- CountryMalaysia
- Language:English
-
Abstract:
Objective: The commonest age of onset for Trichotillomania is between 9 to 13
years of age and at times triggered by Depression and stress. According to
literature, the best treatment is a combination of clomipramine and Cognitive
Behaviour Therapy. The objective of this index case is to present a patient with
an older age of onset, and with co-morbid intellectual disability and the
challenges faced during treatment because of the comorbidity. Methods: A case
of Intellectual disability who presented with Trichotillomania, and Trichophagia
was chosen and followed up for a period of three years. Results: The hair-pulling
behaviour in the index case was due to a strong urge, which was relieved by the
behaviour and was not secondary to other symptoms. The course of
trichotillomania was independent of the course of aggression as improvement in
aggressive symptoms was not accompanied by improvement in hair-pulling
behaviour, which responded to administration of Imipramine, though it did not
improve with clomipramine and citalopram, which are the medications of choice.
Conclusion: The index case suggests customizing treatment according to
individual suitability, and choosing a medication that the patient is comfortable
with, is important. It also suggests true comorbidity between Intellectual
Disability and Trichotillomania, as the symptom of trichotillomania was not
secondary to the aggressive behaviour exhibited by the patient.
- Full text:P020150902579026294662.pdf
