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A Double-Blind Comparison of Clomipramine and Desipramine in the Treatment of Trichotillomania (Hair Pulling)
Abstract
Trichotillomania, an irresistible impulse to pull out one's own hair, is a chronic psychiatric illness that causes severe discomfort, interferes with daily activities, and leads to social isolation. Treatment is usually unsatisfactory. Thirteen women with severe trichotillomania completed a 10-week double-blind, crossover trial of clomipramine, a new tricyclic antidepressant agent with selective antiobsessional effects, and desipramine, a standard tricyclic antidepressant. Treatment with clomipramine resulted in significantly greater improvement in symptoms than desipramine, as indicated by physicians' ratings of the women's clinical progress on a scale in which lower scores indicate improvement (mean [+/- SD] scores: at base line, 10.0; after desipramine treatment, 8.7 +/- 2.4; after clomipramine treatment, 4.7 +/- 3.1; P = 0.006) and by scores on a trichotillomania-impairment scale, in which higher scores indicate greater impairment (at base line, 6.8 +/- 1.7; after desipramine treatment, 6.2 +/- 1.7; after clomipramine treatment, 4.2 +/- 2.7; P = 0.03). The severity of symptoms (mean base-line score, 15.9 +/- 3.8) was reduced more by clomipramine (10.6 +/- 6.4) than by desipramine (14.4 +/- 3.9). The patients reported that the compulsion decreased in intensity and that they were more able to resist the urge to pull out their hair during treatment with clomipramine. We conclude that clomipramine appears to be effective in the short-term treatment of trichotillomania.
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“This scale has reported sensitivity to changes in symptom severity, adequate to excellent interrater reliability, and good concurrent validity with self-reported measures of TTM severity.”
From Dbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial (2012) · cites this paper as Swedo et al., 1989
In the citing paper
“Psychometric data are limited, though inter-rater reliability scores have ranged from adequate to excellent, good concurrent validity has been reported, and scale scores are sensitive to changes in symptom severity with treatment.”
From Dbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial (2012) · cites this paper as Swedo et al., 1989
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Metadata
- Authors
- Swedo, S. E., Leonard, H. L., Rapoport, J. L., Lenane, M. C., Goldberger, E. L., & Cheslow, D. L.
- Affiliations
- National Institute of Mental Health (US)
- ORCID
- Swedo, Susan E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1989-08-24
- Volume
- 321
- Issue
- 8
- Pages
- 497-501
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2325821938
- Cited by
- 601
- References
- 31
- Citations by year
- 2026: 10 · 2025: 6 · 2024: 8 · 2023: 32 · 2022: 7 · 2021: 13 · 2020: 4 · 2019: 10 · 2018: 20 · 2017: 11 · 2016: 12 · 2015: 16 · 2014: 14 · 2013: 9 · 2012: 45
- FWCI
- 35.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- trichotillomania, clomipramine, desipramine, tricyclic antidepressants, compulsive hair pulling, obsessive-compulsive symptoms, treatment efficacy, women
- MeSH terms
- Adolescent, Adult, Clomipramine, Desipramine, Double-Blind Method, Female, Humans, Obsessive-Compulsive Disorder, Trichotillomania
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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