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The Neurobiology of Trichotillomania

Published online by Cambridge University Press:  07 November 2014

Abstract

The neurobiology of trichotillomania (TTM) has only recently received attention from the neuropsychiatrie community, and the number of studies in this area is limited. Nevertheless, there is tentative support for the hypothesis that serotonergic, dopaminergic, and opioid systems mediate hair-pulling symptoms, and that corticostriatal circuits also play a role. An understanding of the neurobiology of TTM may be of value not only for the treatment of this disorder, but also for other stereotypic behaviors.

Type
Feature Article
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Zohar, J, Insel, TR. Obsessive-compulsive disorder: psychobiological approaches to diagnosis, treatment, and pathophysiology. Biol Psychiatry. 1987;22:667687.Google Scholar
2.Leonard, HL, Swedo, SE, Rapoport, JL, et al.Treatment of obsessive-compulsive disorder with clomipramine and desipramine in children and adolescents: a double-blind crossover comparison. Arch Gen Psychiatry. 1989;46:10881092.Google Scholar
3.Swedo, SE, Leonard, HL, Rapoport, JL, et al.A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N Engl J Med. 1989;321:497501.Google Scholar
4.O'Sullivan, RA, Christenson, GA, Stein, DJ. Pharmacotherapy of trichotillomania. In: Stein, DJ, Christenson, GA, Hollander, E, eds. Trichotillomania. Washington, DC: American Psychiatric Press. In press.Google Scholar
5.Pollard, CA, Ibe, IO, Krojanker, DN, et al.Clomipramine treatment of trichotillomania: a follow-up report on four cases. J Clin Psychiatry. 1991;52:128130.Google Scholar
6.Ninan, PT, Rothbaum, BO, Stipetic, M, Risch, SC. CSF 5HIAA as a predictor of treatment response in trichotillomania. Psychopharmacol Bull. 1992;28:451455.Google Scholar
7.Thoren, P, Asberg, M, Bertilsson, L, et al.Clomipramine treatment of obsessive-compulsive disorder. II. Biochemical aspects. Arch Gen Psychiatry. 1980;37:12891294.Google Scholar
8.Stein, DJ, Hollander, E, Cohen, L, Simeon, D, Aronowitz, B. Serotonergic responsivity in trichotillomania: neuroendocrine effects of m-chlorophenylpiperazine. Biol Psychiatry. 1995;37:414416.Google Scholar
9.Stein, DJ, Hollander, E, Simeon, D, et al.Behavioral responses to m-chlorophenylpiperazine and Clonidine in trichotillomania. J Serotonin Res. 1997;4:1115.Google Scholar
10.Goodman, WK, McDougle, CJ, Price, LH, Riddle, MA, Pauls, DL, Leckman, JF. Beyond the serotonin hypothesis: a role for dopamine in some forms of obsessive compulsive disorder? J Clin Psychiatry. 1990;51(suppl):S36S43.Google Scholar
11.Martin, A, Scahill, L, Vitulani, L, King, A. Stimulant use and trichotillomania (letter). J Am Acad Child Adolesc Psychiatry. 1998;37:349350.CrossRefGoogle Scholar
12.Stein, DJ, Hollander, E. Low-dose pimozide augmentation of serotonin reuptake blockers in the treatment of trichotillomania. J Clin Psychiatry. 1992;53:123126.Google Scholar
13.van Ameringen, MA, Mancini, CL. Haloperidol in the treatment of trichotillomania. Poster presented at the 149th Annual Meeting of the American Psychiatric Association. May 9th, 1996: New York, NY.Google Scholar
14.Stein, DJ, Bouwer, C, Hawkridge, S, Emsley, RA. Risperidone augmentation of serotonin reuptake inhibitors in obsessive-compulsive and related disorders. J Clin Psychiatry. 1997;58:119122.Google Scholar
15.Herman, BH. A possible role of proopiomelanocortin peptides in self-injurious behavior. Prog Neuropsychopharmacol Biol Psychiatry. 1990;14(suppl):S109S139.Google Scholar
16.Christenson, GA, Raymond, NC, Faris, PL, et al.Pain thresholds are not elevated in trichotillomania. Biol Psychiatry. 1994;36:347349.Google Scholar
17.Christenson, GA, Crow, JC, Mackenzie, TB. A placebo controlled, double-blind study of naltrexone for trichotillomania. Presented at the Annual Meeting of the American Psychiatric Association; May 9, 1995; Miami, Fla.Google Scholar
18.Christenson, GA, Mackenzie, TB, Mitchell, JE. Characteristics of 60 adult hair pullers. Am J Psychiatry. 1991;148:365370.Google Scholar
19.McGehee, FT Jr, Buchanan, GR. Trichophagia and trichobezoar: etiological role of iron deficiency. J Pediatr. 1980;97:946948.Google Scholar
20.Stein, DJ, Bouwer, C, Van Heerden, B. Pica and the obsessive-compulsive spectrum disorders. S Afr Med J. 1996;86(suppl 12):S1586S1592.Google Scholar
21.Insel, TR. Toward a neuroanatomy of obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:739744.Google Scholar
22.Stein, DJ, Coetzer, R, Lee, M, Davids, B, Bouwer, C. Magnetic resonance brain imaging in women with obsessive-compulsive disorder and trichotillomania. Psychiatry Res. 1997;74:177182.Google Scholar
23.O'Sullivan, RA, Rauch, SL, Breiter, HC, et al.Reduced basal ganglia volumes in trichotillomania measured via morphometric magnetic resonance imaging. Biol Psychiatry. 1997;42:3945.Google Scholar
24.Singer, HS, Reiss, AL, Brown, JE, et al.VolumetriC MRI changes in basal ganglia of children with Tourette syndrome. Neurology. 1993;43:950956.Google Scholar
25.Swedo, SE, Rapoport, JL, Leonard, HL, Schapiro, MB, Rapoport, SI, Grady, CL. Regional cerebral glucose metabolism of women with trichotillomania. Arch Gen Psychiatry. 1991;48:828833.Google Scholar
26.Swedo, SE, Schapiro, MB, Grady, CL, et al.Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Arch Gen Psychiatry. 1989;46:518523.Google Scholar
27.Stein, DJ, van Heerden, B, Wessels, C, et al. Functional imaging and medication in hairpulling. Presented at the Annual Meeting of the American Psychiatric Association; June 12, 1998; San Diego, Calif.Google Scholar
28.Swedo, SE, Leonard, HL, Mittleman, BB, et al.Identification of children with pediatric autoimmune neuropsychiatriC disorders associated with streptococcal infections by a marker associated with rheumatic fever. Am J Psychiatry. 1997;154:110112.Google Scholar
29.Stein, DJ, Wessels, C, Carr, J, Hawkridge, S, Bouwer, C, Kalis, N. Hair-pulling in a patient with Sydenhams chorea. Am J Psychiatry. 1997;154:1320.Google Scholar
30.Swedo, SE, Leonard, HL, Lenane, MC, Rettew, DC. Trichotillomania: a profile of the disorder from infancy through adulthood. Int J Pediatrics. 1992;7:144150.Google Scholar
31.Rettew, DC, Cheslow, DL, Rapoport, JL, et al.Neuropsychological test performance in trichotillomania: a further link with obsessive-compulsive disorder. J Anxiety Disord. 1991;5:225235.Google Scholar
32.keuthen, NJ, Savage, CR, O'Sullivan, RL, et al.Neuropsychological functioning in trichotillomania. Biol Psychiatry. 1996;39:747749.Google Scholar
33.Stein, DJ, Hollander, E, Simeon, D, et al.Neurological soft signs in female trichotillomania patients, obsessive-compulsive disorder patients, and healthy control subject. J Neuropsychiatry Clin Neurosci. 1994;6:184187.Google Scholar
34.Pauls, DL, Towbin, KE, Leckman, JF, Zahner, GE, Cohen, DJ. Gilles de la Tourette syndrome and obsessive compulsive disorder: evidence supporting a genetic relationship. Arch Gen Psychiatry. 1986;43:11801182.Google Scholar
35.Christenson, GA, Mackenzie, TB, Reeve, EA. Familial trichotillomania (letter). Am J Psychiatry. 1992;149:283.Google Scholar
36.Lenane, MC, Swedo, SE, Rapoport, JL, Leonard, H, Sceery, W, Guroff, JJ. Rates of obsessive compulsive disorder in first degree relatives of patients with trichotillomania: a research note. J Child Psychol Psychiatry. 1992;33:925933.Google Scholar
37.Dodman, N, Moon, A, Stein, DJ. Animal models of obsessive-compulsive disorder. In: Hollander, E, Stein, DJ, eds. Obsessive-Compulsive Disorders: Etiology, Diagnosis, Treatment. New York, NY: Marcel Decker; 1997.Google Scholar
38.Rapoport, JL, Ryland, DH, Kriete, M. Drug treatment of canine aeraL lick: an animal model of obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:517521.Google Scholar
39.Dodman, NH, Shuster, L, White, SD, Court, MH, Parker, D, Dixon, R. Use of narcotic agonists to modify stereotypic self-licking, self-chewing, and scratching behavior in dogs. J Am Vet Med Assoc. 1988;193:815819.Google Scholar
40.Hartmann, L. Cats as possible obsessive-compulsive disorder and medication models (letter). Am J Psychiatry. 1995;152;1236.Google Scholar
41.Swanepoel, N, Lee, E, Stein, DJ. Psychogenic alopecia in a cat: response to clomipramine. S Africa J Vet Med. 1998;69:22.Google Scholar
42.Willemse, T, Mudde, M, Josephy, M, Spruijt, BM. The effect of haloperidol and naloxone on excessive grooming behavior of cats. Eur Neuropsychopharmacol. 1994;4:3945.Google Scholar
43.Grindlinger, HM, Ramsay, E. Compulsive feather picking in birds [letter]. Arch Gen Psychiatry. 1991;48:857.Google Scholar