Abstract：
BACKGROUND: Trichotillomania, also known as hair-pulling disorder, is a chronic psychiatric condition with a fluctuating course in which an individual pulls out their hair, leading to visible hair loss and psychosocial sequelae. Due to the unknown pathogenesis, the treatment of this disorder is complex and remains a challenge for dermatologists and psychiatrists. Since guidelines for treating trichotillomania are lacking and, consequently, no common treatment strategy exists, we decided to perform a large-scale, global retrospective cohort study to assess the characterized real-world prescription patterns in treating trichotillomania.
METHODS: The research used the TrinetX database for patients with trichotillomania (ICD 10 - F63.3) within the European and the United States Collaborative Network (EC and UC, respectively). After consulting with a psychodermatology expert, a list of 25 medications was investigated.
RESULTS: Data on the prescription drugs of 1,275 patients from the EC and 109,741 patients from the UC were collected. In both the EC and UC cohorts, benzodiazepine derivatives, particularly lorazepam and midazolam, were the most commonly prescribed sedatives/hypnotics. Antipsychotic prescriptions, primarily haloperidol, followed benzodiazepines. After the trichotillomania diagnosis, notable changes in drug prescriptions for the EC cohort, including an increased likelihood of receiving acetylcysteine, haloperidol, quetiapine, sertraline, olanzapine, and risperidone were observed. The UC cohort showed minimal changes. Overall, both cohorts leaned toward benzodiazepine prescriptions (37% UC, 21% EC) and had limited antidepressant usage. Haloperidol (19.3%) and quetiapine (15.1%) were commonly prescribed in both cohorts.
CONCLUSIONS: The results of our study indicate that the real-world prescription patterns for trichotillomania differ significantly from the expert-proposed therapeutic approach and point toward the necessity of creating standards of pharmacological care and better education.
METHODS: The research used the TrinetX database for patients with trichotillomania (ICD 10 - F63.3) within the European and the United States Collaborative Network (EC and UC, respectively). After consulting with a psychodermatology expert, a list of 25 medications was investigated.
RESULTS: Data on the prescription drugs of 1,275 patients from the EC and 109,741 patients from the UC were collected. In both the EC and UC cohorts, benzodiazepine derivatives, particularly lorazepam and midazolam, were the most commonly prescribed sedatives/hypnotics. Antipsychotic prescriptions, primarily haloperidol, followed benzodiazepines. After the trichotillomania diagnosis, notable changes in drug prescriptions for the EC cohort, including an increased likelihood of receiving acetylcysteine, haloperidol, quetiapine, sertraline, olanzapine, and risperidone were observed. The UC cohort showed minimal changes. Overall, both cohorts leaned toward benzodiazepine prescriptions (37% UC, 21% EC) and had limited antidepressant usage. Haloperidol (19.3%) and quetiapine (15.1%) were commonly prescribed in both cohorts.
CONCLUSIONS: The results of our study indicate that the real-world prescription patterns for trichotillomania differ significantly from the expert-proposed therapeutic approach and point toward the necessity of creating standards of pharmacological care and better education.
摘要：
背景：Trichotillomania，也被称为拔毛症，是一种慢性精神病，病程波动，个体拔掉头发，导致明显的脱发和心理后遗症。由于发病机制不明,这种疾病的治疗是复杂的，对皮肤科医生和精神科医生来说仍然是一个挑战。由于缺乏治疗毛滴虫病的指南，因此,没有常见的治疗策略，我们决定进行大规模的表演，全球回顾性队列研究，以评估在治疗毛滴虫病方面具有特征性的现实世界处方模式。
方法：该研究使用了欧洲和美国合作网络（EC和UC，分别)。在咨询了心理医生之后,调查了25种药物的清单.
结果：收集了来自EC的1,275名患者和来自UC的109,741名患者的处方药数据。在EC和UC队列中，苯二氮卓衍生物，尤其是劳拉西泮和咪达唑仑,是最常用的镇静剂/催眠药。抗精神病药处方,主要是氟哌啶醇,其次是苯二氮卓类药物。在毛滴虫病诊断后，EC队列药物处方的显著变化，包括接受乙酰半胱氨酸的可能性增加，氟哌啶醇,喹硫平,舍曲林,奥氮平,观察到利培酮。UC队列显示最小变化。总的来说,两个队列都倾向于使用苯二氮卓类药物（37%UC，21%EC)，抗抑郁药的使用有限。氟哌啶醇(19.3%)和喹硫平(15.1%)在两个队列中都是常用的。
结论：我们的研究结果表明，现实世界中毛滴虫病的处方模式与专家提出的治疗方法有很大不同，并指出必须建立药理学护理标准和更好的教育。
方法：该研究使用了欧洲和美国合作网络（EC和UC，分别)。在咨询了心理医生之后,调查了25种药物的清单.
结果：收集了来自EC的1,275名患者和来自UC的109,741名患者的处方药数据。在EC和UC队列中，苯二氮卓衍生物，尤其是劳拉西泮和咪达唑仑,是最常用的镇静剂/催眠药。抗精神病药处方,主要是氟哌啶醇,其次是苯二氮卓类药物。在毛滴虫病诊断后，EC队列药物处方的显著变化，包括接受乙酰半胱氨酸的可能性增加，氟哌啶醇,喹硫平,舍曲林,奥氮平,观察到利培酮。UC队列显示最小变化。总的来说,两个队列都倾向于使用苯二氮卓类药物（37%UC，21%EC)，抗抑郁药的使用有限。氟哌啶醇(19.3%)和喹硫平(15.1%)在两个队列中都是常用的。
结论：我们的研究结果表明，现实世界中毛滴虫病的处方模式与专家提出的治疗方法有很大不同，并指出必须建立药理学护理标准和更好的教育。
