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Anorexia nervosa is an eating behavior disorder that is often related to various personality factors. The relationship between obsessive compulsive disorder and eating Disorders has been highlighted.
Objectives
To present a clinical case of a patient with eating disorder and gastric bezoar, secondary to compulsive hair ingestion.
Methods
Bibliographic review of articles published in relation to the comorbidity of these disorders, based on articles published in the last 5 years in Pubmed.
Results
26-year-old female. Diagnosis of restrictive anorexia nervosa. She was admitted to the hospital on two occasions for nutritional disorders. In the last admission, she reported greater anxiety and significant weight loss. She reports that she has limited her food intake, but she does feel thin and is unable to eat for fear of gaining weight. Ruminative thoughts about her body image. During admission, the patient expressed a sensation of fullness, nausea and vomiting, later observing in abdominal X-ray and gastroscopy, the presence of a gastric trichobezoar, which was finally resolved conservatively.
Conclusions
Trichotillomania is observerd in 1 in 2000 people, trichophagia is even less frequent. According to DSM- V, these disorders are grouped within obsessive-compulsive spectrum disorders. A Trichobezoar is a conglomerate that can be found in the stomach or intestine, composed mainly of hair, previously ingested. Trichotillomania can be associated with anorexia nervosa, especially in patients with obsessive personality traits, which occurs frequently. The gastric slowing that patients with anorexia often present is a factor that favors the formation of the bezoar
Trichotillomania is a disorder characterized by the compulsive pulling out of one’s own hair. It usually starts just before or after puberty, and about 1 to 2% of people have this disorder. But its incidence is variable over the years and socio-demographic data.
Objectives
Describe the profile of children and adolescents consulting for trichotillomania.
Methods
An incidence survey was carried out among children and adolescents followed for trichotillomania at the out-patient unit of child psychiatry (Monastir - Tunisia) from January 2003 to September 2020.
Results
Among the 11000 patients who were followed during the study period, 47 patients presented trichotillomania, corresponding to a rate of 0.42%. Three of them presented with associated trichophagia and two were operated on in pediatric surgery for trichobezoar. A female predominance was noted with a sex-ratio of 0.37. The average age was 9.3 years with extremes ranging from 2 to 15 years. Almost all of the patients were in school. Most of the patients were referred by dermatologists. We retained in these patients: 17% presented an attachment disorder, 14.8% had a depressive disorder, 6.3% had anxiety elements, 6.3% had an intellectual disability, 4.2% had an associated enuresis and one case had a GAD. The treatment was to undergo behavioral measurements or CBT in 91.4%. Pharmacological management was carried out in 46.8% of patients and was mainly based on antidepressants.
Conclusions
Trichotillomania is a disorder that can be stressful for patients as well as their families. Better knowledge of the profile of these patients is necessary in order to better therapeutic efficacy.
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