什么是trichotillomania（TTM）？

拔毛发癖是什么?

Trichotillomania(TTM), also known as hair-pulling disorder, is a condition in which the affected person repeatedly pulls out, twists out, or breaks off hair from any part of the body for non-cosmetic reasons.

People with trichotillomania will pull out head hair as well as eyelashes, eyebrows, and/or hair on other parts of the body, such as the underarm, pubic, chin, chest, or leg areas. They may pull out their hair intentionally or unconsciously.

Trichotillomania在最新的精神障碍诊断和统计手册中被分类为（DSM-5）作为obsessive-compulsive spectrum disorder。

症状

根据针对身体重复性的重复行为的TLC基础，Trichotillomania可以来，停止在重新核时停止几天甚至几个月。睡眠中甚至甚至据报道了毛发行为。

虽然Trichotillomania可以根据该人表现出不同的方式，但它通常有五个不同的特点：

1. 反复拉出一个人的头发，导致明显的脱发
2. An increasing sense of tension immediately prior to pulling out the hair or when attempting to resist the behavior
3. 拔出头发时的快乐，满足感或救济
4. The disturbance is not better accounted for by another mental disorder and is not due to a general medical condition such as alopecia areta
5. 干扰导致社会，职业或其他重要领域的临床痛苦或损伤

The following rituals and behavioral patterns often precede pulling:

• 通过头发梳理
• 感觉单个毛发
• 拖着毛发
• 在视觉上寻找头皮和发际线

Causes and Risk Factors

虽然没有人知道肯定会导致三胞嘧啶，生物力量以及行为，学习和心理成分都被认为发挥作用。

Trichotillomania是一种相对罕见的疾病，影响人口的1％至2％。Trichotillomania可以影响所有年龄段的人;然而，孩子和青少年似乎比成年人更常见。大约90％的成年人的病症是女性。

家史

拥有一个家庭成员或亲戚与三胞瘤的风险提高了该病症的风险，这表明该条件可能是遗传部件。一项双胞胎研究表明，遗传性估计为76.2％，表明遗传学发挥着重要作用。

共同发生条件

Trichotillomania通常伴有其他精神疾病，包括：

• 抑郁症
• 概念（皮肤采摘障碍）
• Toutette的综合症
• 其他强迫性疾病

Diagnosis

因为毛状体瘤蓟可以类似于与脱发相关的其他医疗条件Alopecia Areta.，Trichotillomania的诊断通常需要皮肤病学和精神病学评估。诊断可能是复杂的，因为Alopecia Areata本身有时会引发三胞嘧啶。

小孩子

In very young children, trichotillomania has been compared to other habits such as thumb sucking or nail-biting. Children less than 5 years old often pull their hair out unknowingly. In the same way that thumb-sucking stops spontaneously for most children, the majority of children who begin to pull their hair at this early age will stop on their own.

Preadolescents and Young Adults

Trichotillomania经常从9和13岁之间开始。有趣的是，在这个年龄段受Trichotillomania影响的大多数人（70％至90％）是女性。在这个年龄段的人中，Trichotillomania往往是慢性的。

In addition, these individuals often have oral rituals associated with hair pulling, such as chewing or licking the lips, or even the eating of hair. Approximately 1% to 3% of college-aged individuals in the U.S. have trichotillomania.

治疗

治疗of trichotillomania is often unnecessary for very young children as they usually grow out of it. However, for people with adolescent-onset trichotillomania, treatment may be necessary, especially if it is suspected that the person is also consuming the pulled hair, which can cause dangerous blockages in the gastrointestinal system.

心理治疗

认知行为技巧在治疗三胞嘧啶症方面表现出一些疗效。突出的是习惯逆转疗法，旨在帮助人们发展减少有害行为的技能，包括：

• Self-monitoring (awareness training)
• Identification of behavior triggers
• Modifying the environment to decrease the likelihood of pulling behavior
• 识别与头发拉动不相容的替代行为

药物

目前，有限的证据表明药物如选择性血清素再摄取抑制剂（SSRIS）要么三环抗抑郁药（TCA）始终有效治疗三胞嘧啶，因此FDA尚未批准任何药物以具体治疗病症。然而，已经尝试了几种类型的药物，特别是如果存在共同发生的情绪，焦虑或强迫症状。这些包括：

• Anafranil (clomipramine)
• Depakote (valproate)
• Lithobid, Eskalith (lithium carbonate)
• Luvox（Fluvoxamine）
• paxil（paroxetine）
• prozac（氟西汀）
• Zoloft (sertraline)
• Naltrexone
• 神经抑制剂

应对

虽然应对三胞嘧啶的最佳方式取决于您的年龄和症状的严重程度，但您还有一些策略或您的孩子尝试：

• 找到一个健康的替代习惯。尝试挤压压力球，处理纹理物体，或绘制 - 或询问您的医疗专业人员对其他一些想法。
• 练习放松技巧。Given that trichotillomania oftencoexists with other mental illnesses，学习和练习放松技术有助于，包括深呼吸，介意冥想和渐进放松。
• Make a chart.每天都在没有拉扯你的头发，在条纹后添加贴纸或复选标记并奖励自己。尝试将图表挂在一个房间里，你倾向于拔出你的头发。
• 寻求支持。这是永远s helpful to talk with others who understand what you’re going through. TheTLC基金会提供各种在线支持小组以及在缩放上的每周社区聚会。