Head trauma and brain injury are common causes of emergency cases, and predispose multiple psychiatric complications. The head trauma, itself, often occurs after some psychiatric disorders, like mood or substance related disorders. So, the complex interaction of these factors often causes difficulties in diagnosis and management of the patients. The side effects of surgical and medical treatments may also entangles these processes. Here we presents the history of a young adult patient with this collection of factors, i.e.: head trauma, delirium, and substance use. Then we discuss about the differential diagnosis and management.
Aim and Background: The purpose of the present study was to compare the effect of cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and pharmacotherapy on severity of trichotillomania (TTM) symptoms. Methods and Materials: The participants consisted of 8 women and 1 man of over 16 years of age with TTM. The subjects were chosen through convenience sampling and randomly divided into 3 groups of equal size (CBT, ACT, and pharmacotherapy groups). The present single-subject study was conducted using the A-B design. The baseline consisted of 3 sessions, and the intervention consisted of 10 weekly sessions of CBT and ACT once a week for 60 minutes and 10 pharmacotherapy sessions once every 2 weeks. One month after the intervention, the subjects participated in 3 follow-up sessions (once a month). Massachusetts General Hospital Hairpulling Scale (MGH-HPS) was used to collect data. Findings: The findings of this study were analyzed based on visual analysis and descriptive statistical indicators. The results demonstrated that CBT and ACT were, respectively, more effective on the reduction of TTM symptoms severity and pharmacotherapy was the least effective. Conclusions: Considering the effectiveness of CBT and ACT on severity of TTM symptoms, the use of these therapies to reduce TTM symptoms is recommended.
