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Bull Menninger Clin. 2019 Winter;83(1):97-104. doi: 10.1521/bumc.2019.83.1.97.

Electroconvulsive therapy for trichotillomania in a bipolar patient.

Author information

1
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
2
D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
3
Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences (MICCN) and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
4
ECT Service, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

A recent review on the use of electroconvulsive therapy (ECT) in obsessive-compulsive-related disorders (OCRDs) identified reports of trichotillomania (TTM) in only three patients, but it did not describe the specific effect of ECT on hair-pulling behaviors. The authors present a case report of Mrs. A, a 77-year-old widowed housewife with a lifelong history of episodic TTM and bipolar disorder who was effectively treated with ECT. However, on each attempt to withdraw ECT, her condition deteriorated. Eventually, a decision was made to maintain ECT (one session every week), which resulted in no further relapse over the followup period. ECT shows some potential promise for reducing hair-pulling behaviors in the context of severe depression.

KEYWORDS:

bipolar disorder; consultation-liaison psychiatry; electroconvulsive therapy; self-injury; trichotillomania

PMID:
30888852
DOI:
10.1521/bumc.2019.83.1.97

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