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A Placebo-Controlled Trial of Cognitive-Behavioral Therapy and Clomipramine in Trichotillomania
Abstract
BACKGROUND: The major treatments reported to be effective in the treatment of trichotillomania are cognitive-behavioral therapy (CBT) with habit reversal and serotonin-norepinephrine reuptake inhibitors such as clomipramine. However, the 2 treatments have not been previously compared with each other. This study examines the efficacy of CBT and clomipramine compared with placebo in the treatment of trichotillomania. METHOD: Twenty-three patients with trichotillomania as determined by the Structured Clinical Interview for DSM-III-R entered and 16 completed a 9-week, placebo-controlled, randomized, parallel-treatment study of CBT and clomipramine. Efficacy was evaluated by the Trichotillomania Severity Scale, the Trichotillomania Impairment Scale, and the Clinical Global Impressions-Improvement scale, which were conducted by an independent assessor blinded to the treatment condition. RESULTS: CBT had a dramatic effect in reducing symptoms of trichotillomania and was significantly more effective than clomipramine (p = .016) or placebo (p = .026). Clomipramine resulted in symptom reduction greater than that with placebo, but the difference fell short of statistical significance. Placebo response was minimal. CONCLUSION: Clinicians should be aware of the potential treatments available for trichotillomania. A larger and more definitive study comparing CBT and a serotonin-norepinephrine reuptake inhibitor is indicated.
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“These findings are in line with most previous research (Woods et al., 2006b; Ninan et al., 2000; van Minnen et al., 2003; Schuck et al., 2011) and call for further development and improvement of TTM- and SPD-treatments.”
From Internet-delivered acceptance-based behavior therapy for trichotillomania and skin-picking disorder in a psychiatric setting: A feasibility trial (2022) · cites this paper as Ninan et al., 2000
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Abramowitz, J. S., Taylor, S., & McKay, D. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60240-3 · Cited by 1,002
(2000) · doi:10.1002/1520-6394(2000)12:1+
Self-citationWoods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.006 · Cited by 381
Loebel, A. D., Cucchiaro, J. B., Silva, R., Kroger, H., Hsu, J., Sarma, K., & Sachs, G. S. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13070984 · Cited by 343
Pathophysiology of obsessive–compulsive disorder
Aouizerate, B., Guehl, D., Cuny, E., Rougier, A., Bioulac, B., Tignol, J., & Burbaud, P. (2004) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2004.02.004 · Cited by 341
Metadata
- Authors
- Ninan, P. T., Rothbaum, B. O., Marsteller, F. A., Knight, B. T., & Eccard, M. B.
- Affiliations
- Emory University (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2000-01-15
- Volume
- 61
- Issue
- 1
- Pages
- 47-50
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2993744382
- Cited by
- 303
- References
- 0
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 6 · 2023: 25 · 2022: 2 · 2021: 8 · 2020: 8 · 2019: 15 · 2018: 14 · 2017: 13 · 2016: 10 · 2015: 17 · 2014: 14 · 2013: 10 · 2012: 37
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (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, cognitive behavioral therapy, clomipramine, habit reversal, serotonin-norepinephrine reuptake inhibitors, placebo response, treatment efficacy
- MeSH terms
- Adult, Clomipramine, Double-Blind Method, Female, Humans, Male, Middle Aged, Placebos, Psychiatric Status Rating Scales, Severity of Illness Index, Trichotillomania, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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