TRICHOTILLOMANIA

Trichotillomania (Trich) is an impulse control disorder characterized by repeated pulling of the hair, often leading to bald spots. A patient suffering from Trichotillomania typically pulls hair from one specific spot on the body in a habitual, repeated way. Head hair, nose hair, eyebrows, and pubic hair are all common areas for Trich. The disorder is thought to be an amalgum of Obssessive Cmpulsive and Movement disorders. Since many people suffering from Trich are not even aware that they are pulling out their hair when they are doing it, many place it in the same category as nail biting, which has a similar habitual pattern.

Trichotillomania has an estimated prevalence rate of 1% worldwide. It is thought that the disorder was previously under reported but that reporting has increased in the past decades as the stigma surrounding compulsive disorders has lessened and psychological care has become more ubiquitous.

There are very stong indications that Trich is hereditary. Scientists isolated a gene they believed to be responsible for the behavior, and when they injected lab rats with it, those rats started to rip out their own and others hair. Stress is a common trigger for Trich behavior. Most trich patients will show no hair pulling behavior in a stress-free situation, but will immediately engage in the behavior when presented with stress.

Treatment often includes both behavioral and drug therapy. Tricyclic antidepressants are more effective than SSRIs (like prozac) in the treatment of Trich. Behavioral treatments have to do with understanding what situations serve as triggers for the behavior in order to increase awareness and develop strategies to avoid engaging in the behavior in those situations.

CAPGRAS DELUSION

Associated with Schizophrenia, brain damage, and dementia, the Capgras Delusion is characterized by a patient being convinced that a loved one has been imprisoned and that an impostor has taken his or her place. Capgras Delusion is characterized as a delusional misidentification syndrome, though some researchers believe that the Capgras Delusion should not be considered a syndrome, but rather a symptom related to underlying causes.

The Capgras Delusion is named after Joseph Capgras, a French psychiatrist who first described the ailment in 1923 in a paper coauthored by Reboul-Lachaux.

It is believed that the Capgras Delusion is caused by a breakdown in the part of the brain responsible for creating the appropriate emotional resonse to visual stimuli. When a person suffering from this disorder sees the face of a loved one, they can recognize the person, but do not feel the appropriate emotional response leading them to believe that something is not right and that the person is not really the person they know and love.

In the case of schizophrenia, which makes up the majority of Capgras cases, the delusion can be treated with antipsychotic medication.

Since this sick is not terminal, but can lead to immense emotional pain and even violence, I rate it a
1 on my "lethality scale" (1-10)
and a 5 on my "disturbing scale" (1-10)

CONVERSION DISORDER

Conversion Disorder is a psychiatric ailment in which a patient experiences physical symptoms which, upon testing, have no physical cause. Conversion Disorder can cause an amazingly variable array of physical symptoms including blindness, pain, numbness, paralysis or fits.

A diagnosis of Conversion Disorder is made after thorough health screening by doctors to exclude physical or neurological causes for the symptoms.

The following diagnostic criteria have been set for Conversion Disorder by the DSM IV:

• One or more symptoms or deficits are present that affect voluntary motor or sensory function suggestive of a neurologic or other general medical condition.
• Psychological factors are judged, in the clinician's belief, to be associated with the symptom or deficit because conflicts or other stressors precede the initiation or exacerbation of the symptom or deficit. A diagnosis where the stressor precedes the onset of symptoms by up to 15 years is not unusual.
• The symptom or deficit is not intentionally produced or feigned (as in factitious disorder or malingering).
• The symptom or deficit, after appropriate investigation, cannot be explained fully by a general medical condition, the direct effects of a substance, or as a culturally sanctioned behavior or experience.
• The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
• The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of somatization disorder, and is not better accounted for by another mental disorder.

Conversion disorder is treated by carefully and neutrally explaining the disorder to the patient, psychological or psychoactive treatment of anxiety/depression, and physiotherapy to alleviate symptoms.

I rate this sick a
1 on my "lethality scale" (1-10)
and a 4 on my "disturbing scale" (1-10)

MUNCHAUSEN SYNDROME

Munchausen syndrome is a psychological illness in which the sufferer will fake or induce the symptoms of illness or injury in order to receive the attentions of medical personel.

The odd name for this syndrome is taken from Baron Münchhausen who lived from 1720-1797 and purportedly told many impossible stories about his own fictitious adventures.

People who develop Munchausen have often experienced childhood trauma or neglect from sick parents whose illnesses made them unavailable.

Lethality: 1

Disturbing: 3