What does that mean......impulse control disorder? Very simply, as the words imply, inability to control one's impulses in relation to a specific behavior. Being included in the DSM-IV (Diagnositic & Statistical Manual for Mental Health/Psychiatric Diagnoses, 4th Edition) indicates that the disorder is one which causes impairments in life's functioning. Otherwise, it would not be classified in the DSM-IV manual.
Impulse control disorders are, as with many/most mental health diagnoses, reflections of the brain's inability to produce properly balanced chemicals of the endocrine system. Thus, it is referred to as a disorder that involves neuropsychiatry. Neuropsychiatry's focus is lent to learning, comprehending and lending efforts to restore the brain's homeostasis in relation to brain chemistry. Clearly, not an easy task.
***The following information is directly attributed to the U.S. National Library of Medicine, PubMed Health. Note all references at end of copied material.***
Trichotillomania is hair loss from repeated urges to pull or twist the hair until it breaks off. Patients are unable to stop this behavior, even as their hair becomes thinner.
It may affect as much as 4% of the population. Women are four times more likely to be affected than men.
These symptoms are usually seen in children:
For others, trichotillomania is a lifelong disorder. However, treatment often improves the hair pulling and the feelings of depression, anxiety, or poor self image.
Causes, incidence, and risk factors
Trichotillomania is a type of impulsive control disorder. Its causes are not clearly understood.It may affect as much as 4% of the population. Women are four times more likely to be affected than men.
Symptoms
Symptoms usually begin before age 17. The hair may come out in round patches or across the scalp. The effect is an uneven appearance. The person may pluck other hairy areas, such as the eyebrows, eyelashes, or body hair.These symptoms are usually seen in children:
- An uneven appearance to the hair
- Bare patches or all around (diffuse) loss of hair
- Bowel blockage (obstruction) if people eat the hair they pull out
- Constant tugging, pulling, or twisting of hair
- Denying the hair pulling
- Hair regrowth that feels like stubble in the bare spots
- Increasing sense of tension before the hair pulling
- Other self-injury behaviors
- Sense of relief, pleasure, or gratification after the hair pulling
- Feeling sad or depressed
- Anxiety
- Poor self image
Signs and tests
Your health care provider will examine your skin, hair, and scalp. A piece of tissue may be removed (biopsy) to find other causes, such as a scalp infection, and to explain the hair loss.Treatment
Experts don't agree on the use of medication for treatment. However, naltrexone and selective serotonin reuptake inhibitors (SSRIs) have been shown effective in reducing some symptoms. Behavioral therapy and habit reversal may also be effective.Expectations (prognosis)
Trichotillomania that begins in younger children (less than 6 years old) may go away without treatment. For most people, the hair pulling ends within 12 months.For others, trichotillomania is a lifelong disorder. However, treatment often improves the hair pulling and the feelings of depression, anxiety, or poor self image.
Complications
People can have complications when they eat the pulled-out hair (trichophagia). This can cause a blockage in the intestines or lead to poor nutrition.Prevention
Early detection is the best form of prevention because it leads to early treatment. Decreasing stress can help, because stress may increase compulsive behavior.References
- Morelli JG. Disorders of the hair. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 654.
- Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 23.
- Kratochvil CJ, Bloch MH. Trichotillomania across the life span. J Am Acad Child Adolesc Psychiatry. 2009;48:879-883.
- Review Date: 2/13/2012.Reviewed by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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