Facts on File Encyclopedia of Health and Medicine

the reverse is more true. Many people are relieved
to be able to discuss their fears and worries and
are receptive to less drastic solutions that perhaps
previously had not occurred to them. All states in
the United States provide for involuntary hospital-
ization of people who present clear danger to
themselves, though most have stringent criteria
for determining whether such hospitalization is
appropriate. Other preventive measures include
appropriate treatment for the underlying psycho-
logic condition or psychiatric disorder and close
supervision or monitoring.
See also END OF LIFE CONCERNS; STRESS AND STRESS
MANAGEMENT.

trichotillomania Compulsively pulling out one’s
HAIR such that hair loss occurs and is obvious.
Pulling the hair results in a sense of relief from
stress or anxiety. Trichotillomania often begins in
early ADOLESCENCEand is more common in girls.
There is commonly a precipitating event that is
stressful or traumatic, though some research sug-
gests the fluctuating hormonal environment
within the body during PUBERTYmay trigger the

condition. Some psychiatrists believe trichotillo-

mania is a form of OBSESSIVE–COMPULSIVE DISORDER

(OCD) because many people who have trichotillo-

mania also engage in some degree of compulsive

behavior such as counting rituals or repetitiously

washing the hands. As well, the current therapeu-

tic approach for trichotillomania is treatment with

a combination of BEHAVIOR MODIFICATION THERAPY

and medications such selective serotonin reuptake

inhibitors (SSRIs) and the antiseizure medication

valproate. These are the same medications used to

treat OCD. People who are successful in changing

their behavior often experience long-term relief,

although the trichotillomania may return in times

of intense stress.

COMMON MEDICATIONS TO TREAT TRICHOTILLOMANIA

clomipramine fluoxetine

lithium carbonate paroxetine

sertraline valproate

See also ALOPECIA; ANTIDEPRESSANT MEDICATIONS;

DEPRESSION; GENERALIZED ANXIETY DISORDER (GAD);

STRESS AND STRESS MANAGEMENT.

386 Psychiatric Disorders and Psychologic Conditions