Трихотилломания: современное состояние проблемы и аспекты клинической типологии

Д.В. Романов, М.А. Самушия, Ю.Ю. Романова, И.В. Плужников, Е.А. Парфенов, А.В. Миченко, А.Н. Львов

Аннотация


Трихотилломания представляет собой значимое психодерматологическое расстройство, актуальность проблемы изуче-
ния которого обусловлена значительной распространенностью сфокусированного на волосах аутоагрессивного поведения,
гиподиагностикой, выраженным влиянием на качество жизни и психологическими последствиями, неопределенностью психо-
патологической структуры и противоречивостью данных о нейробиологическом субстрате расстройства, недостаточной эф-
фективностью доступной терапии. Материалы и методы. Комплексным клиническим методом, дополненным данными три-
хоскопии, с участием специалистов междисциплинарной психодерматологической группы обследована пилотная выборка из
20 больных трихотилломанией (3 мужчин, 17 женщин, средний возраст 26,6± 13,2 года). Результаты. Представлена об-
щая клиническая характеристика обследованной выборки, включая дифференциально-диагностические дерматоскопические
признаки аутодеструктивной патологии волос. Выделено три психодерматологических варианта аутоэкстракции волос: наи-
более частый – компульсивный (12 наблюдений – 60%), менее распространенный – импульсивный (6 наблюдений – 30%),
наиболее редкий – диссоциативный (2 наблюдения – 10%). Предложенные варианты соотнесены с единственной доступной
по данным литературы типологией трихотилломании – сфокусированной и автоматической аутоэкстракцией.


Ключевые слова


трихотилломания, аутодепиляция, травматическая алопеция, экстракция волос, психопатология, эпи- демиология, типология, трихоскопия, терапия.

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