University of Medicine and Dentistry, New Jersey Medical School, Newark, NJ, USA.
Psychosomatics. 2010 Sep-Oct;51(5):443-6. doi: 10.1176/appi.psy.51.5.443.
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.
The authors discuss a rare presentation of a case of recurrent Rapunzel syndrome in a 37-year-old woman.
The authors present a biopsychosocial treatment plan for a therapeutic approach.
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.
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.
拔毛癖（对毛发的痴迷）在 100 多年前的文献中首次被描述，并于 1987 年被美国精神病学协会确认为一种独特的疾病。
作者讨论了一位 37 岁女性复发性长发公主综合征的罕见病例。
作者提出了一个生物心理社会治疗计划作为治疗方法。
该患者的发病年龄相对较晚、反复发作、与胰腺炎有关，以及她食用的是人造假发而非自己的头发，这使她的情况变得独特。该患者出现小肠梗阻，需要进行剖腹手术。手术后，她接受了精神科服务的评估；出院后，她取下了假发，继续服用规定的药物，参加了一个精神科项目，并由家人和朋友进行监测。
目前尚无治疗拔毛癖的明确指南。在本例中，喹硫平、去除假发、家庭参与和定期随访有助于她最初停止拔毛。抗抑郁药物有助于控制这种强迫观念，而行为治疗和家庭参与则为习惯逆转训练提供了手段。
