Meliha ZENGİN EROĞLU, Ebru SAHAN, Mehmet Emin DEMİRKOL, Volkan GELEGEN, Lut TAMAM

Trikotillomani tanılı hastalarda dürtüsellik ve dikkat eksikliği hiperaktivite bozukluğu

Amaç: Bu çalışmada trikotillomani hastalarında dürtüsellik ve erişkin dikkat eksikliği ve hiperaktivite bozukluğunu değerlendirmeyi amaçladık.Gereç ve Yöntem: Birincil ya da eş tanı olarak trikotillomani tanısı konulan ve dahil edilme kriterlerine uygun olan hastalar çalışmaya dahil edildi. Veriler retrospektif olarak toplandı. Minnesota Dürtü Kontrol Bozuklukları Görüşmesi (MIDI), Barratt İmpulsivite Ölçeği (BİÖ), Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu tanı ve değerlendirme envanteri, Wender Utah Derecelendirme Ölçeği (WUDÖ) uygulandı.Bulgular: Çalışmaya trikotillomani tanısı olan 40 ve erişkin dikkat eksikliği hiperaktivite bozukluğu + trikotillomanisi olan 18 hasta dahil edildi. Her iki grubun sosyodemografik özellikleri birbirine benzerdi. Patolojik kumar oynama erişkin dikkat eksikliği hiperaktivite bozukluğu + trikotillomani grubunda daha sıktı. Erişkin dikkat eksikliği hiperaktivite bozukluğu + trikotillomani grubu, erişkin dikkat eksikliği hiperaktivite bozukluğu tanı ve değerlendirme envanterinin dikkat eksikliği alt ölçeklerinden istatistiksel olarak anlamlı düzeyde daha yüksek puan aldı..Sonuç: Trikotillomani hastalarında erişkin dikkat eksikliği ve hiperaktivitenin daha çok dikkat eksikliğiile ilişkili olduğunu, dürtüselliğin ise her iki bozuklukta ortak bir özellik olduğunu göstermiştir.

Anahtar Kelimeler:

trikotilomani, dürtüsellik, dürtü kontrol bozuklukları, DEHB, bedene yönelik tekrarlayıcı davranış bozuklukları

Attention deficit hyperactivity disorder and impulsivity in patients with trichotillomania

Purpose: The aim of this study was to assess impulsivity and attention deficit hyperactivity disorder in adult patients with trichotillomania.Materials and Methods: Subjects diagnosed with trichotillomania primary or comorbid to other psychiatric disorders who met the inclusion criteria were enrolled in the study. Data were collected retrospectively. Minnesota Impulse Control Disorders Interview Scale (MIDI), the Barratt's Impulsivity Scale (BIS), Adult ADD/ADHD DSM IV- Based Diagnostic Screening and Rating Scale, Wender Utah Rating Scale (WURS) were evaluated.Results: 40 patients with trichotillomania and 18 patients with trichotillomania + adult attention deficit hyperactivity disorder were included in the study. Sociodemographic characteristics of two groups were similar. Rate of pathologic gambling was higher in trichotillomania + adult attention deficit hyperactivity disorder group. Trichotillomania + adult attention deficit hyperactivity disorder group had statistically higher scores from attention deficit part of Adult ADD/ADHD DSM IV- Based Diagnostic Screening and Rating Scale. Conclusion: Adult attention deficit hyperactivity is more related to attention deficit in trichotillomania patients and impulsivity is a common feature in both disorders.

Keywords:

trichotillomania, impulsivity, impulse control disorders, ADHD, body-focused repetitive behavior disorders,

PDF

___

1. Christenson GA, Pyle RL, Mitchell JE. Estimated lifetime prevalence of trichotillomania in college students. J Clin Psychiatry. 1991;52:415-7.
2. Woods DW, Flessner CA, Franklin ME, Keuthen NJ, Goodwin RD, Stein DJ et al. The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization. J Clin Psychiatry. 2006;67:1877- 88.
3. McElroy SL, Hudson JI, Pope H, Jr., Keck PE, Jr., Aizley HG. The DSM-III-R impulse control disorders not elsewhere classified: clinical characteristics and relationship to other psychiatric disorders. Am J Psychiatry. 1992;149:318-27.
4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV-TR), 4th edition text revision. Washington DC, American Psychiatric Association. 2000.
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-III-R), 3rd edition revised. Washington DC, American Psychiatric Association. 1987.
6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5), 5th edition. Washington DC, American Psychiatric Association. 2013.
7. Leppink EW, Redden SA, Grant JE. Impulsivity in body-focused repetitive behavior disorders: Disparate clinical associations between three distinct measures. Int J Psychiatry Clin Pract. 2016;20:24-31.
8. Moeller FG, Barratt ES, Dougherty DM, Schmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry. 2001;158:1783-93.
9. Golubchik P, Sever J, Weizman A, Zalsman G. Methylphenidate treatment in pediatric patients with attention-deficit/hyperactivity disorder and comorbid trichotillomania: a preliminary report. Clin Neuropharmacol. 2011;34:108-10.
10. Mansueto CS, Stemberger RM, Thomas AM, Golomb RG. Trichotillomania: a comprehensive behavioral model. Clin Psychol Rev. 1997;17:567-77.
11. Odlaug BL, Chamberlain SR, Schreiber LR, Grant JE. Where on the obsessive impulsive-compulsive spectrum does hair-pulling disorder belong? Int J Psychiatry Clin Pract. 2013;17:279-85.
12. Stein DJ, Christenson GA, Hollander E. Trichotillomania. Washington DC, American Psychiatric Press. 1999.
13. Christenson GA, Mackenzie TB, Mitchell JE. Characteristics of 60 adult chronic hair pullers. Am J Psychiatry. 1991;148:365.
14. Diefenbach GJ, Tolin DF, Hannan S, Crocetto J, Worhunsky P. Trichotillomania: impact on psychosocial functioning and quality of life. Behav Res Ther. 2005;43:869-84.
15. Chamberlain SR, Fineberg NA, Blackwell AD, Clark L, Robbins TW, Sahakian BJ. A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania. Neuropsychologia. 2007;45:654-62.
16. Chamberlain SR, Fineberg NA, Blackwell AD, Robbins TW, Sahakian BJ. Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. Am J Psychiatry. 2006;163:1282-4.
17. Grant JE, Odlaug BL, Chamberlain SR. A cognitive comparison of pathological skin picking and trichotillomania. J Psychiatr Res. 2011;45:1634-8.
18. Odlaug BL, Chamberlain SR, Derbyshire KL, Leppink EW, Grant JE. Impaired response inhibition and excess cortical thickness as candidate endophenotypes for trichotillomania. J Psychiatr Res. 2014;59:167-73.
19. van Minnen A, Hoogduin KA, Keijsers GP, Hellenbrand I, Hendriks GJ. Treatment of trichotillomania with behavioral therapy or fluoxetine: a randomized, waiting-list controlled study. Arch Gen Psychiatry. 2003;60:517-22.
20. Bhanji NH, Margolese HC. Alternative pharmacotherapy for trichotillomania: a report of successful bupropion use. J Clin Psychiatry. 2004;65:1283.
21. King RA, Scahill L, Vitulano LA, Schwab-Stone M, Tercyak KP, Jr., Riddle MA. Childhood trichotillomania: clinical phenomenology, comorbidity, and family genetics. J Am Acad Child Adolesc Psychiatry. 1995;34:1451-9.
22. Stanley MA, Hannay HJ, Breckenridge JK. The neuropsychology of trichotillomania. J Anxiety Disord. 1997;11:473-88.
23. King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A et al. An epidemiological study of trichotillomania in Israeli adolescents. J Am Acad Child Adolesc Psychiatry. 1995;34:1212-5.
24. Reeve EA, Bernstein GA, Christenson GA. Clinical characteristics and psychiatric comorbidity in children with trichotillomania. J Am Acad Child Adolesc Psychiatry. 1992;31:132-8.
25. Keren M, Ron-Miara A, Feldman R, Tyano S. Some reflections on infancy-onset trichotillomania. Psychoanal Study Child. 2006;61:254-72.
26. Lochner C, du Toit PL, Zungu-Dirwayi N, Marais A, van Kradenburg J, Seedat S et al. Childhood trauma in obsessive-compulsive disorder, trichotillomania, and controls. Depress Anxiety. 2002;15:66-8.
27. Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R. Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample. Addict Behav. 2014;39:1272-7.
28. Hartmann AS, Rief W, Hilbert A. Impulsivity and negative mood in adolescents with loss of control eating and ADHD symptoms: an experimental study. Eat Weight Disord. 2013;18:53-60.
29. Ertan Y, Lut T. Attention-deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia. Neuropsychiatr Dis Treat. 2018;14:1883–9.
30. Chen HJ, Lee YJ, Yeh GC, Lin HC. Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study. Pediatr Res. 2013;73:492-6.
31. First MB, Spitzer R, Gibbon M, Williams JB. Structured clinical interview for DSM-IV clinical version (SCID-I/CV), Washington DC: American Psychiatric Press. 1997.
32. Öztürkçügil A, Aydemir Ö, Yıldız MDA, Köroğlu IV E. DSM-IV Eksen I Bozuklukları için yapılandırılmış klinik görüşmenin (SCID-I) Türkçeye uyarlanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:233-6.
33. Christenson GA, Faber RJ, de Zwaan M, Raymond NC, Specker SM, Ekern MD et al. Compulsive buying: descriptive characteristics and psychiatric comorbidity. J Clin Psychiatry. 1994;55:5–11.
34. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51:768-74.
35. Güleç H, Tamam L, Turhan M, Karakuş G, Zengin M, Stanford MS. Psychometric properties of the Turkish version of the Barratt Impulsiveness Scale11. Klinik Psikofarmakol Bült. 2008;18:251-8.
36. Günay Ş, Savran C, Aksoy UM. Marmara Üniversitesi Atatürk Eğitim Fakültesi Eğitim Bilimleri Dergisi. Erişkin Dikkat Eksikliği Hiperaktivite Ölçeğinin (Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale) dilsel eşdeğerlilik, geçerlik, güvenirlik ve norm çalışması. 2006;21:133-50.
37. Ward MF. The Wender Utah Rating Scale: an aid in the retrospective. Am J Psychiatry. 1993;1:885.
38. Oncü B, Olmez S, Sentürk V. Validity and reliability of the Turkish version of the Wender Utah Rating Scale for attention-deficit/hyperactivity disorder in adults. Turk Psikiyatri Derg. 2005;16:252-9.
39. Block RM, Macdonald NP, Piotrowski NP. Attention deficit hyperactivity disorder (ADHD). 2014. In: Magill’s medical guide (online edition). Available from: https://www.scribd.com/document/345185531/69 1-Adhd-Paper. (accessed Sep 2019).
40. Porteret R, Bouchez J, Baylé F, Varescon I. ADH/D and impulsiveness: Prevalence of impulse control disorders and other comorbidities, in 81 adults with attention deficit/hyperactivity disorder (ADH/D). L'Encephale. 2016;42:130-7.
41. Chamberlain SR, Harries M, Redden SA, Keuthen NJ, Stein DJ, Lochner C et al. Cortical thickness abnormalities in trichotillomania: international multisite analysis. Brain Imaging Behav. 2018;12:823-8.
42. Becher T, Weise SJN. Trichotillomania under a therapy with Lisdexamfetamine. Neuropediatrics. 2016;47(S 01):P08-1.
43. Akaltun İ, Kara T. Atomoxetine-related trichotillomania in a boy with attentiondeficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2017;27:923.
44. Ayaydın H. Probable emergence of symptoms of trichotillomania by atomoxetine: a case report. Psychiatry and Clinical Psychopharmacology. 2019;29:220-2.
45. Türkoglu S, Çetin FH. Atomoxetine in the treatment of adolescent with trichotillomania and attentiondeficit/hyperactivity disorder. Clin Neuropharmacol. 2018;41:84-5.
46. Johnson J, El-Alfy AT. Review of available studies of the neurobiology and pharmacotherapeutic management of trichotillomania. J Adv Res. 2016;7:169-84.