Obsessive-compulsive disorder, trichotillomania, and anorexia nervosa: A case report

Abstract

We report a case study of an 18‐year‐old female who presented with symptoms associated with several discrete diagnostic syndromes: obsessive‐compulsive disorder, trichotillomania, major depression, and anorexia nervosa. Improvement in each occurred after treatment with the serotonin selective reuptake inhibitor, fluoxetine, suggesting that such syndromes share a common serotonin neurotransmitter disturbance. Furthermore, the combined effects of medication and psychotherapy resulted in improvement in assertiveness, sense of security, self‐worth, flexibility, and self‐regulation. We discuss the pharmacological and psychotherapeutic implications of possible psychophysiologic similarities among the previously mentioned syndromes. © 1995 by John Wiley & Sons, Inc.

Obsessive compulsive disorder as a cause of atypical eating disorder: a case report

“…In this case report, OCD symptoms clearly preceded the reduction of food intake and were responsible for severe weight loss that closely mimicked AN. The association of well-characterised anorexia nervosa and OCD clinical cases has already been described in the literature either as a single comorbidity (Fisher & Fornari, 2002;Gee & Telew, 1999;Iancu & Kikenzon, 1993;Thiel & Boocks, 1995) or as an association with varied somatic conditions (Lazaro & Moreno, 2005;Pryor & Martin, 1995;Raitasuo & Virtanen, 1998). Nevertheless, to our knowledge, this is the first case report in which the obsessive and compulsive symptoms were primarily responsible for a great impairment in eating habits.…”

“…From the neurobiological point of view, serotonin plays a role in both OCD and ED. Some authors have postulated that ED may be a variant of OCD based on neurobiological findings (Pryor and Martin, 1995). Indeed, both patients with AN and OCD present higher levels of 5-hydroxyindolacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) than controls and both bulimics and OCD patients present a blunted response to m-clorophenylpiperazine test as compared to controls (Hsu & Kaye, 1993).…”

Hypnosis as a Vehicle for Choice and Self-Agency in the Treatment of Children with Trichotillomania

“…Pharmacological treatments for Trichotillomania have included the use of the selective serotonin reuptake inhibitor fluoxetine (Pryor, Martin & Roach, 1995). The authors reported favorable results from fluoxetine in their case study of an 18-yearold female with Trichotillomania.…”

“…Their OCD group demonstrated a higher incidence of depressive disorders and Axis II personality disorders. Pryor, Martin and Roach (1995) reported on the efficacy of treating both Trichotillomania and OCD with the serotonin selective reuptake inhibitor fluoxetine, suggesting that such syndromes could share a common serotonin neurotransmitter disturbance, which suggests possible psychophysiologic similarities between these two syndromes. The literature indicates that Trichotillomania in children is more likely to present in pure form, or that the symptom of hair pulling comes without any additional observable psychopathology (Zalman, Hermesh & Sever, 2001;Rowen, 1981;Kohen, 1996;Watson & Allen, 1993).…”

Trichotillomanie

“…Meist kommen trizyklische Antidepressiva, selten auch MAO-Hemmer zum Einsatz. Bei Kombination mit zwanghaften Verhaltensweisen wurde Fluoxetin erfolgreich eingesetzt [9]. Die Nebenwirkungen sind hierbei jedoch beachtlich, so daß eine sehr strenge Indikationsstellung gefordert wird.…”