Extended follow-up of a comprehensive behavioral (ComB) treatment sample during the COVID-19 pandemic

Abstract

This study provides the longest follow-up yet for comprehensive behavioral (ComB) treatment of trichotillomania (TTM) (M = 24.59 months after pre-treatment and 15.92 months after the last follow-up point in a recent clinical trial (CITATION MASKED), which had shown ComB to be significantly more efficacious than minimal attention at post-treatment). This study also examined changes in TTM severity from before to during the COVID-19 pandemic. Participants ( N = 23) completed a survey assessing current TTM symptoms, the impact of the pandemic on their coping with TTM, and their experience with ComB treatment. Self-reported symptom severity at this follow-up evaluation fell between the scores obtained at the clinical trial’s pre-treatment assessment and at its last follow-up before the pandemic and did not significantly differ from either time point. Most participants (73%) reported some change in their TTM management since onset of the pandemic, with changes to their environment/routine (61%) and in anxiety (32%) being the most common. Pandemic-related changes were associated with variable outcomes, improving symptoms and management for some while worsening them for others. Use of strategies from ComB had declined since the most recent follow-up, but more than half (55%) of participants reported that strategies from ComB remained useful.

Reply to “Diagnosis of stress-associated dermatological conditions in New York City safety net hospitals during the pandemic”

“…We find this particularly important as subsequent literature examining the influence of COVID-19 stressors on trichotillomania severity have predominantly been described in the pediatric population, for which there are relatively few dermatologic specialists. [3][4][5] Additionally, the increase in telogen effluvium reported by the authors also underscores the importance of obtaining a complete hair history and thorough scalp examination to exclude trichotillomania.…”

Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies

“…The most studied conditions were mood disorders (nine studies) 37,38,43,44,46,49–51,53 and obsessive‐compulsive and related disorders (seven studies) 40,41,45,47,48,51,54 . Only three papers each reported on anxiety disorders 38,44,51 and eating disorders 39,42,52 .…”

“…Three studies 39,42,52 evaluated problematic eating symptoms in patients with preexisting eating disorders, and all employed the Eating Disorder Examination‐Questionnaire. There were six studies 40,41,45,47,48,54 that assessed obsessive‐compulsive symptoms using dissimilar scales in patients with preexisting obsessive‐compulsive and related disorders, including one study 41 of patients with trichotillomania. One study 50 assessed manic symptoms in patients with bipolar disorder.…”

“…We included 18 studies, [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] with a total sample size of 4465. All but three studies 45,49,54 were conducted in high-income countries, and a total of 10 countries were represented.…”

Comprehensive Behavioral Treatment of an Older Adult Man with Trichotillomania

“…In Summer 2020, we conducted an additional follow-up evaluation, not part of the initial plan for the clinical trial, to find out how our TTM patients were faring during the COVID-19 pandemic (Flannery et al, 2022, in press). Walter participated in this follow-up study and again reported abstinence, scoring 0 on both the MGH-HPS and a self-report version of the TSS (all assessments in this pandemic follow-up were conducted online).…”