“Pulling hair out of the head” - the importance of traumatic family events in the development and maintenance of trichotillomania symptoms - case report

Aleksandra Siek 1 , Agata Makarewicz 1 , Łukasz Łobejko 1 , Anna Gralewska 1 , Joanna Tomaka 1 , Justyna Szymańska-Piekarczyk 1 , Jakub Siembida 3 ,  and Hanna Karakuła Juchnowicz 2
  • 1 I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin
  • 2 Department of Clinical Neuropsychiatry, Medical University of Lublin
  • 3 Student Research Group at the I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin


Introduction: Trichotillomania is a mental disorder characterized by a repetitive and compulsive hair pulling, classified in ICD-10 to a group of habit and impulse disorders, and in the DSM-5 to the group of obsessive-compulsive disorders.

Aim: The aim of the study is to present on the basis of case study:1). the importance of traumatic family experiences in releasing as well as maintaining the symptoms of Trichotillomania, 2). comprehensive medical care, the application of which has resulted in a beneficial therapeutic effect.

Results: In the described case of 16-year-old patient, Trichotillomania was triggered by traumatic events related to lack of support and family stabilization resulting from parental disputes and grandfather’s death, when she was 11 years old. The subsequent years of her life, in spite of the divorce of her parents and their separate residence, abounded in periods of turbulent quarrels between the parents in which she was involved. Each time this type of incident was associated with the recurrence of behavior associated with Trichotil-lomania, the course of which was more severe with the occurrence of self-harm and suicidal thoughts.

Conclusions: 1. In the described case, traumatic events and pathological relations of the immediate family members were not only thetriggering factor, but also maintaining the Trichotillomania symptoms. 2. In accordance with the guidelines of Trichotillomania Learning Center-Scientific Advisory Board (2008), the use of a comprehensive treatment including both the patient - individual psycho-therapy (especially cognitive-behavioral therapy) and pharmacotherapy, as well as her family (family psychotherapy, family mediation, workshops for parents), brought about positive therapeutic effects.

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