Trichotillomania
Psychiatrymedium
A 41-year-old woman under marital stress reports a mounting urge to pull out her scalp hair, followed by relief once she does. Examination shows patchy areas of hair loss with broken hairs of varying lengths and no scaling or inflammation. Which is the most likely diagnosis?
- A.TrichotillomaniaCorrect
- B.Alopecia areata
- C.Generalized anxiety disorder
- D.Body dysmorphic disorder
Explanation
Recurrent pulling out of one's own hair with resulting patchy loss, broken hairs of differing lengths, and a tension-relief cycle defines trichotillomania, a body-focused repetitive behavior classified within the obsessive-compulsive spectrum. Alopecia areata shows smooth, well-defined bald patches without broken hairs.
Why each option
- A.
- Self-pulling with a tension-relief cycle and broken hairs defines trichotillomania.
- B.
- Alopecia areata gives sharply demarcated smooth patches without broken hairs.
- C.
- Generalized anxiety disorder does not involve the focused hair-pulling behavior.
- D.
- Body dysmorphic disorder centers on appearance preoccupation, not hair pulling.
Reference: DSM-5-TR, 2022
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