Group treatment for trichotillomania: cognitive-behavioral therapy versus supportive therapy.

Abstract

OBJECTIVE:

Trichotillomania is a psychiatric condition characterized by the chronic pulling and plucking of one's own hair. Cognitive-behavioral therapy shows promise as a treatment for trichotillomania and might be preferable to pharmacotherapy. However, there have been no randomized, controlled studies of the efficacy of group cognitive-behavioral therapy.

METHOD:

We evaluated 44 subjects, recruited from April 2009 to May 2010, all of whom met DSM-IV criteria for a diagnosis of trichotillomania. Subjects were randomized to receive 22 sessions of either group cognitive-behavioral therapy or group supportive therapy (control). Treatment evaluation was non-blind and used self-report scales. The primary outcome measure was the improvement of hair-plucking behavior as assessed by the Massachusetts General Hospital Hairpulling Scale. Secondary measures included scores on the Beck Depression Inventory, the Beck Anxiety Inventory, and the Social Adjustment Scale-Self-Report.

RESULTS:

Both groups showed significant posttreatment improvement in the scores from the Massachusetts General Hospital Hairpulling Scale (F = 23.762, P < .001) and the Beck Depression Inventory (F = 6.579, P = .003). The decrease in hair-plucking behavior over time was significantly greater in the study group than in the control group (F = 3.545, P < .038). There were no significant differences between the pretreatment and posttreatment time points or between the groups in the scores from the Beck Anxiety Inventory and the Social Adjustment Scale-Self-Report.

CONCLUSIONS:

We conclude that group cognitive-behavioral therapy is a valid treatment for trichotillomania. This treatment model should be further revised and expanded to address comorbidities such as anxiety and social maladjustment.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT01968343.

• Authors: Edson Luiz Toledo, Enilde De Togni Muniz, Antônio Marcelo Cabrita Brito, Cristiano Nabuco de Abreu, Hermano Tavares
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 76 Issue 4 Pg. 447-55 (Apr 2015) ISSN: 1555-2101 [Electronic] United States
• PMID: 25271779 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © Copyright 2015 Physicians Postgraduate Press, Inc.

Topics

• Adult
• Brazil
• Cognitive Behavioral Therapy (methods)
• Female
• Follow-Up Studies
• Humans
• Male
• Psychotherapy, Group (methods)
• Self-Help Groups
• Trichotillomania (diagnosis, psychology, therapy)