251. A placebo-controlled trial of cognitive-behavioral therapy and clomipramine in trichotillomania
- Author
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Frederick A. Marsteller, Barbara O. Rothbaum, Mary B. Eccard, Philip T. Ninan, and Bettina T. Knight
- Subjects
Adult ,Male ,Clomipramine ,medicine.medical_specialty ,Impulse control disorder ,medicine.medical_treatment ,Habit reversal training ,Placebo-controlled study ,Placebo ,behavioral disciplines and activities ,Severity of Illness Index ,Placebos ,Trichotillomania ,Double-Blind Method ,medicine ,Humans ,Trichotillomania (hair-pulling disorder) ,Psychiatric Status Rating Scales ,Cognitive Behavioral Therapy ,business.industry ,Middle Aged ,medicine.disease ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Treatment Outcome ,Physical therapy ,Cognitive therapy ,Female ,business ,Selective Serotonin Reuptake Inhibitors ,medicine.drug - Abstract
Background: The major treatments reported to be effective in the treatment of trichotillomania are cognitive-behavioral therapy (CBT) with habit reversal and serotonin-norepinephrine reuptake inhibitors such as clomipramine. However, the 2 treatments have not been previously compared with each other. This study examines the efficacy of CBT and clomipramine compared with placebo in the trcatment of trichotillomania. Method: Twenty-three patients with trichotillomania as determined by the Structured Clinical Interview for DSM-III-R entered and 16 completed a 9-week, placebo-controlled, randomized. parallel-treatment study of CBT and clomipramine. Efficacy was evaluated by the Trichotillomania Severity Scale, the Trichotillomania Impairment Scale, and the Clinical Global Impressions-Improvement scale, which were conducted by an independent assessor blinded to the treatment condition. Results: CBT had a dramatic effect in reducing symptoms of trichotillomania and was significantly more effective than clomipramine (p = .016) or placebo (p = .026). Clomipramine resultcd in symptom reduction greatcr than that with placebo, but the difference fell short of statistical significance. Placebo response was minimal. Conclusion: Clinicians should be aware of the potential treatments available for trichotillomania. A larger and more definitive study comparing CBT and a serotonin-norepinephrine reuptake inhibitor is indicated.
- Published
- 2000