Body focused repetitive disorders

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Body focused repetitive disorders

Psychological disorders

Mood disorders

Major depressive disorder

Suicide

Bipolar disorder

Seasonal affective disorder

Premenstrual dysphoric disorder

Anxiety disorders

Generalized anxiety disorder

Social anxiety disorder

Panic disorder

Agoraphobia

Phobias

Obsessive-compulsive disorders

Obsessive-compulsive disorder

Body focused repetitive disorders

Body dysmorphic disorder

Stress-related disorders and abuse

Post-traumatic stress disorder

Physical and sexual abuse

Psychotic disorders

Schizoaffective disorder

Schizophreniform disorder

Delusional disorder

Schizophrenia

Cognitive and dissociative disorders

Delirium

Amnesia

Dissociative disorders

Eating disorders

Anorexia nervosa

Bulimia nervosa

Personality disorders

Cluster A personality disorders

Cluster B personality disorders

Cluster C personality disorders

Somatoform and factitious disorders

Somatic symptom disorder

Factitious disorder

Substance use disorders and drugs of abuse

Tobacco dependence

Opioid dependence

Cannabis dependence

Cocaine dependence

Alcohol use disorder

Sleep disorders

Bruxism

Nocturnal enuresis

Insomnia

Night terrors

Narcolepsy (NORD)

Sexual dysfunction disorders

Erectile dysfunction

Male hypoactive sexual desire disorder

Orgasmic dysfunction

Female sexual interest and arousal disorder

Genito-pelvic pain and penetration disorder

Pediatric disorders

Attention deficit hyperactivity disorder

Disruptive, impulse control, and conduct disorders

Learning disability

Fetal alcohol syndrome

Tourette syndrome

Autism spectrum disorder

Rett syndrome

Shaken baby syndrome

Enuresis

Encopresis

Psychiatric emergencies

Suicide

Serotonin syndrome

Neuroleptic malignant syndrome

Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review

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Body focused repetitive disorders

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Body focused repetitive disorders

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Questions

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A 17-year-old girl is brought to the physician by her mother due to recent hair loss. The mother tells the physician that she has noticed a gradual loss of hair on her daughter’s head over the past 3 months. The daughter is embarrassed by her appearance and always tries to cover her hair with a hat. When interviewed alone, the patient tells the physician she sometimes plucks hair off her head. She has tried multiple times to stop this behavior, but she has been unable to do so. She adds that she feels excessive stress before hair pulling that is resolved when she pulls her hair. Which of the following will be most likely seen on microscopic examination of the hair follicles and the scalp of this patient?

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Tanner Marshall, MS

Contributors

Body-focused repetitive disorders is an umbrella term in the DSM-5 for disorders where individuals compulsively damage their physical appearance.

These used to be classified as impulse-control disorders, but now belong in the family of obsessive-compulsive disorders.

Two of the more well-known ones are trichotillomania, which is a hair-pulling disorder, and excoriation, which is a skin-picking disorder.

Obsessive-compulsive disorders are usually defined by psychological obsessions—thoughts, urges, and images that are unwanted, intrusive, and recurrent—as well as behavioral compulsions exhibited physically in response to the obsessions.

For body-focused repetitive disorders, though, the self-damaging behavior isn’t usually related to a conscious psychological obsession, but occurs instead when a person feels stressed, anxious, or even bored.

Once a person starts engaging in the self-damaging behavior, there’s usually a strong urge to keep doing it over and over again.

This can happen in multiple short episodes throughout the day, or during single long sessions that can last for hours at a time.

People with body-focused repetitive disorders aren’t always fully aware of their behavior while engaged in the compulsion, making it difficult to stop.

These behaviors are distinct from intentional behaviors aimed at improving physical appearance, like plucking one’s eyebrows.

They’re also not attributable to problems stemming from disorders like substance abuse, like, for example, the skin-picking associated with amphetamine or cocaine use.

Body-focused repetitive disorders don’t include compulsions resulting from other mental disorders, like picking at skin during a tactile hallucination, when someone thinks bugs are crawling under their skin.

They’re unrelated to behaviours made in response to irritating stimuli from other illnesses, like scratching at an itchy scabies rash.

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