INTRODUCTION:
Trichotillomania (TTM) is a condition characterized by repetitive hair pulling those results in hair loss, distress and disability in daily functioning [1]. This condition has a global prevalence of 1-2% in the general population [2,3]. Although TTM is typically considered an isolated disorder, emerging evidence suggests that it may be associated with other psychiatric conditions, including obsessive-compulsive disorder (OCD), eating disorders (EDs), major depressive disorder (MDD), anxiety disorders, substance use disorder and attention-deficit/hyperactivity disorder (ADHD) [2–5].
In a recent study predictor of having an OCD in a TTM population were examined and it was discovered that having an eating disorder diagnosis was linked to a higher risk for OCD depending on how severe the ED was [6]. It also suggests that OCD might be a factor in predicting the prevalence of an eating disorder in TTM populations [7].
Attention-deficit/hyperactivity disorder (ADHD) is also commonly comorbid with other psychiatric conditions, with up to 75% of adults with ADHD meeting diagnostic criteria for at least one more psychiatric disorder [8]. It is a condition that affects the development of the brain, identified by signs of inattentiveness, hyperactivity, and impulsivity. In approximately 60% of cases, these symptoms can continue into adulthood [9]. Despite this growing body of evidence, the relationship between trichotillomania, bulimia nervosa and ADHD remains poorly understood. In light of the limited research on this topic, this case report aims to provide a detailed description of a TTM patient with comorbid BN, MDD and ADHD.