Longitudinal Follow-Up of Naturalistic Treatment Outcome in Patients With Trichotillomania
J Clin Psychiatry 2001;62(2):101-107
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Little is known about the
longitudinal course of treatment outcome in patients with
trichotillomania. The authors conducted a second follow-up
assessment on a cohort of hair pullers previously studied.
Method: Forty-four subjects completed a
hair-pulling questionnaire and paper-and-pencil measures of
hair-pulling severity and impact, psychosocial functioning,
depression, anxiety, and self-esteem. Mean time elapsed between
the first and second follow-up assessment was 2.5 years (index
evaluation to first follow-up = 3.5 years).
Results: Twenty-seven subjects (61.4%) had
active treatment since the first follow-up. No significant
changes in hair pulling, depression, anxiety, or psychosocial
functioning were reported from first to second follow-up.
Self-esteem scores significantly worsened during this period (p =
.000). A trend toward worsening also existed for psychosocial
impact scores. Comparison of scores at index evaluation with
second follow-up still showed significant improvement over time
for hair pulling (p = .001) but significant worsening in
self-esteem (p = .000). Treatment and responder status were
unrelated to clinical functioning, with the exception of
depression and psychosocial impact.
Conclusion: Although hair pullers exhibit
initial improvement with treatment, scale scores plateau or
worsen by second follow-up. Significant worsening in self-esteem
at second follow-up may be related to the absence of further
improvements in hair-pulling severity. Future research should
focus on the interrelationships among self-esteem, depression,
and hair pulling during treatment for this disorder.