Treatment of recurrent Rapunzel syndrome and trichotillomania: Case report and literature review

Guy C. Jones, Karl Coutinho, Devashish Anjaria, Najeeb Hussain, Rashesh Dholakia

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: Trichotillomania (obsession with one's hair) was first described in the literature over 100 years ago and was recognized by the American Psychiatric Association as a distinct disorder in 1987. Objective: The authors discuss a rare presentation of a case of recurrent Rapunzel syndrome in a 37-year-old woman. Method: The authors present a biopsychosocial treatment plan for a therapeutic approach. Results: This patient was unique for her relatively advanced age at onset, the recurrent nature, association with pancreatitis, and the consumption of artificial hair extensions, rather than her own hair. This patient presented with small-bowel obstruction requiring laparotomy. After surgery, she was evaluated by the psychiatric service; after discharge, she removed her hair extensions, continued to take her prescribed medication, attended a psychiatric program, and was monitored by family and friends. Conclusion: There are no definitive guidelines for treating trichotillomania. In this case, quetiapine, hair-extension removal, family involvement, and regular follow-up helped with the initial cessation of her hair consumption. Antidepressant treatment helped control the obsession while behavioral therapy and family involvement provided the means for habit-reversal training.

Original languageEnglish (US)
Pages (from-to)443-446
Number of pages4
JournalPsychosomatics
Volume51
Issue number5
DOIs
StatePublished - 2010
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

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