Single Modality Versus Dual Modality Treatment for Trichotillomania: Sertraline, Behavioral Therapy, or Both?
J Clin Psychiatry 2006;67(7):1086-1092
© Copyright 2016 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Trichotillomania is a
psychiatric condition characterized by chronic hair
pulling. Both cognitive behavioral therapy (CBT) and
the selective serotonin reuptake inhibitors
(SSRIs) have shown promise in the treatment of
trichotillomania, with comparison studies favoring
CBT over pharmacotherapy. However, no randomized, controlled studies to date have compared the
efficacy of individual SSRI or CBT treatment to
the combination of both treatment modalities.
Method: In this study, which ran from
February 2000 through April 2003, subjects who met DSM-IV criteria for trichotillomania were
randomly assigned to treatment with sertraline or placebo in a double-blind study design.
Following 12 weeks of active pharmacotherapy,
subjects not demonstrating significant
trichotillomania symptom improvement had habit reversal
training (HRT) added to their treatment regimen.
Primary outcome measures were the Hair Pulling
Scale and the Clinical Global Impressions scale.
Results: Thirteen subjects completing the
22-week study received single modality treatment
of either sertraline or HRT, and 11 received both modalities of treatment. Trichotillomania
symptoms in both groups improved, although the
dual modality treatment group demonstrated larger gains and were much more likely to reach
responder status at final evaluation.
Conclusion: These results suggest that
the combination of sertraline and HRT may be more efficacious in the treatment of
trichotillomania than either approach alone.