Body-Focused Repetitive Disorder: A Case Report of Trichotillomania and Onycothilomania with Social Phobia in a 30-year-old Woman

DOI

10.2991/978-94-6463-310-8_17How to use a DOI?

Keywords

Trichotillomania; Onychotillomania; Social anxiety

Abstract

Background

Trichotillomania (TTM) and Onycothilomania are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as dermatological conditions categorized as obsessive-compulsive disorders. Based on DSM-5, OCRD (Obsessive Compulsive and Related Disorders) includes BFRB (Body Focused Repetitive Behaviour), which includes Trichotillomania (TTM), Skin picking disorder (SPD), Onychophagia, and Onychotillomania. TTM is characterized by repeated or repetitive hair pulling, which results in baldness/hair loss that is visible. Onychotillomania is defined as repetitive picking or pulling of the nail unit, causing damage to the nail matrix, nail bed, nail plate and periungual skin.

Case Report: We reported the case of a 30-year-old woman who initially came to the hospital with recurrent infection of the fingers and was diagnosed with Trichotillomania and onycothilomania. The patient experienced baldness on the right and left temporal scalps with irregular shapes. All the twenty fingernails and toes of the patient are short. Inability to withstand impulses and feelings of relief after doing chronic repetitive behaviour repeatedly felt clearly by patients for ten years. Due to her condition, she becomes afraid and anxious to meet new people, fears being judged by others, and avoids socialization. Patients get standard treatment for Trichotillomania and Onycothilomania through SSRI and Cognitive Behavioral Therapy and consult a dermatologist for hair and nail treatment.

Discussion

This Patient was diagnosed with Trichotillomania and onychotillomania because of fulfilling the five criteria according to the DSM-5, which are: the behaviour of pulling hair and nails repeatedly causing hair loss and nail damage, there is a repeated urge to hold the behaviour, there is a feeling of satisfaction, relief and/or enjoyment after pulling hair and nails, hair pulling behaviour causes social or occupational functioning to interfere with other vital functions, hair pulling behaviour is not caused by another medical condition (e.g., other dermatological conditions), and hair and nail pulling activities not caused by another mental disorder. The patient was given SSRI therapy in the form of Sertraline 50 mg/day to reduce their anxiety disorders. The patient was given CBT (Cognitive Behavioural Therapy) psychotherapy, especially habit reversal training (HRT), with the aim that the patient understand the causes of their illness so that attitudes and beliefs improve in the patient.

Conclusion

The Patient was diagnosed with Trichotillomania and onychotillomania with comorbid social anxiety. Stressors in patients are due to conflict in the family. Pharmacotherapy and psychotherapy are given to this patient. The patient also consulted dermatology for hair and nail treatment.

Copyright

© 2023 The Author(s)

Open Access

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TY  - CONF
AU  - Lastri Diyani Siregar
AU  - Vita Camellia
PY  - 2023
DA  - 2023/12/18
TI  - Body-Focused Repetitive Disorder: A Case Report of Trichotillomania and Onycothilomania with Social Phobia in a 30-year-old Woman
BT  - Proceedings of the 6th International Conference of Neuroscience, Neurology and Psychiatry Universitas Sumatera Utara (ICONAP 2023)
PB  - Atlantis Press
SP  - 115
EP  - 120
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6463-310-8_17
DO  - 10.2991/978-94-6463-310-8_17
ID  - Siregar2023
ER  -