The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
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
Citations
Cites
Obsessive-Compulsive Disorder in Children and Adolescents
Swedo, S. E. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810040041007 · Cited by 817
Schedule for Affective Disorders and Schizophrenia
Endicott, J., & Spitzer, R. (2014) · PsycTESTS Dataset · doi:10.1037/t07870-000 · Cited by 678
Clomipramine Treatment of Obsessive-Compulsive Disorder: I. A Controlled Clinical Trial
Thorén, P. (1980) · Archives of General Psychiatry · doi:10.1001/archpsyc.1980.01780240079009 · Cited by 497
Clomipramine Treatment of Childhood Obsessive-Compulsive Disorder: A Double-blind Controlled Study
Flament, M. F. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790330057007 · Cited by 466
The Leyton Obsessional Inventory
Cooper, J. E. (1970) · Psychological Medicine · doi:10.1017/s0033291700040010 · Cited by 461
Clomipramine and Exposure for Obsessive-Compulsive Rituals: 1
Marks, I. M., Stern, R. S., Mawson, D. C., Cobb, J., & McDonald, R. T. (1980) · The British Journal of Psychiatry · doi:10.1192/bjp.136.1.1 · Cited by 449
A Structured Interview for the DSM-III Personality Disorders
Stangl, D. K. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790290073008 · Cited by 443
Insel, T. R. (1983) · Archives of General Psychiatry · doi:10.1001/archpsyc.1983.04390010015002 · Cited by 348
Obsessive-compulsive disorder and serotonin: Is there a connection?
Insel, T. R., Mueller, E. A., Alterman, I., Linnoila, M., & Murphy, D. L. (1985) · Biological Psychiatry · doi:10.1016/0006-3223(85)90176-3 · Cited by 343
Hudak, R., & Gannon, J. M. (2022) · Current clinical practice · doi:10.1007/978-3-030-98709-1_5 · Cited by 306
Research works printed but not linked: 9
- Hallopeau, 1889, Ann Dermatol Venereol, 10, 440
- Jillson, 1983, Cutis, 31, 383
- Sorosky, 1980, Adolesc Psychiatry, 8, 437
- Galski, 1983, Psychoanal Rev, 70, 331
- Childers, 1958, J Clin Exp Psychopathol, 19, 141
- Krishnan, 1984, J Clin Psychiatry, 45, 267
- Sachdeva, 1987, J Indian Med Assoc, 85, 151
- Montgomery, 1980, Pharm Med, 1, 189
- Murphy DL, Pickar D, Alterman IS. Methods for the quantitative assessment of depressive and manic behavior. In: Burdock EL, Sudilovsky A, Gershon S, eds. The behavior of psychiatric patients: quantitative techniques for evaluation. Experimental and clinical psychiatry. Vol. 7. New York: Marcel Dekker, 1982:355–92.
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“have a chronic and often treatment-resistant course [ 50 , 51 ].”
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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
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