Journal of Mental Health and Aging

HUNGRY AND STRESSED? TAKE A MOUTHFUL OF THIS AWFUL DELICACY

World Summit on PSYCHIATRY DISORDERS, MENTAL HEALTH AND WELLNESS
June 24-25, 2019 | Philadelphia, USA

Durva Balkrishna Sail, Babhulkar S, Kadam K, Thakur S S, Umrajkar H and Kulkarni P S

B J Medical College and Sassoon General Hospital, India

Scientific Tracks Abstracts : J Ment Health Aging

Abstract:

Background: Trichotillomania has a prevalence of 0.6%–1.6% with a strong female predilection and typically affecting patients in childhood and adolescence mainly. Approximately 30% of patients who suffer from trichotillomania also engage in trichophagia. Some studies have reported a 25%-37.5% prevalence of trichobezoar in those who engage in trichophagy. If trichobezoars may continue to grow past the pylorus, the situation is called Rapunzel syndrome which was first described by Vaughan et. al in 1968. It is found that many of the patients have psychiatric pathology such as emotional problems, family discord and history of neglect or mental retardation. Hence psychiatric intervention is an important part of management to prevent recurrence.

Case: A 13 years old female child referred to psychiatry from surgery in view of trichobezoar. On detailed evaluation, she reported that she experiences anxiety features in the form of worrying thoughts and palpitations following stressor in the form of domestic violence and physical abuse at hostel. Following this she started experiencing persistent pervasive low mood, anhedonia, irritability, decreased appetite and easy fatigability. In response to her anxiety she started plucking her hair and used to eat them to relieve it. During course of illness her school performance also deteriorated. Diagnosis of childhood depression was made and patient was started on Tab. Sertraline 25mg which was up titrated to 37.5mg and she is maintained well on same. X-ray abdomen, USG abdomen, CT abdomen was done S/O Rapunzel syndrome and was operated for same.

Conclusion: Childhood depression with concomitant anxiety may present as trichotillomania as an attempt to alleviate the mounting anxiety by hair pulling. So, attempt should be made to rule out co morbid depression in cases presenting as trichotillomania.

Biography:

Durva Balkrishna Sail is a Resident Doctor in Department of Psychiatry at BJ Government Medical College and Sassoon General Hospital, India. She was graduated from Topiwala National Medical College and BYL Nair Hospital Mumbai at the age of 23 years. She has published her original research paper in Journal of Evidence Based Medicine and presented poster at 44th Annual Conference of Research Society BJGMC, Pune. She has presented the topic titled “Minor physical anomalies in depression” for A V Shah award at Annual West Zone conference. She has presented the topic titled “Atypical Kliene Levin syndrome” for Professor M Murrugappan award at Annual National conference of Indian Psychiatric Society. She was selected as ADMO at Indian Railways.

E-mail: durvasail@gmail.com

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