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N -Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial

Bloch, Michael H., M.D., M.S ; Panza, Kaitlyn E., B.A ; Grant, Jon E., J.D., M.D., Ph.D ; Pittenger, Christopher, M.D., Ph.D ; Leckman, James F., M.D

Journal of the American Academy of Child and Adolescent Psychiatry, 2013-03, Vol.52 (3), p.231-240 [Periódico revisado por pares]

Maryland Heights, MO: Elsevier Inc

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Título:
N -Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial
Autor: Bloch, Michael H., M.D., M.S ; Panza, Kaitlyn E., B.A ; Grant, Jon E., J.D., M.D., Ph.D ; Pittenger, Christopher, M.D., Ph.D ; Leckman, James F., M.D
Assuntos: Acetylcysteine ; Acetylcysteine - administration & dosage ; Acetylcysteine - adverse effects ; Acetylcysteine - pharmacology ; Adolescence ; Adolescent ; Adolescents ; Anxiety ; Behavior Modification ; Behavior Problems ; Biological and medical sciences ; Child ; Child clinical studies ; Child psychology ; Children ; Children & youth ; Comorbidity ; Depression ; Depression (Psychology) ; Dermatology ; Double-Blind Method ; Drug Therapy ; Female ; Free Radical Scavengers - administration & dosage ; Free Radical Scavengers - adverse effects ; Free Radical Scavengers - pharmacology ; Hair and nails disorders ; Humans ; Intervention ; Male ; Medical sciences ; Mental depression ; Mental health care ; Miscellaneous ; N-acetylcysteine ; Outcome Measures ; Outcomes of Treatment ; Pediatrics ; Placebos ; Psychiatric Status Rating Scales ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; randomized controlled trial ; Severity (of Disability) ; Severity of Illness Index ; Statistical analysis ; Treatment Outcome ; trichotillomania ; Trichotillomania - drug therapy
É parte de: Journal of the American Academy of Child and Adolescent Psychiatry, 2013-03, Vol.52 (3), p.231-240
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Abstract Objective To examine the efficacy of N -acetylcysteine (NAC) for the treatment of pediatric trichotillomania (TTM) in a double-blind, placebo-controlled, add-on study. Method A total of 39 children and adolescents aged 8 to 17 years with pediatric trichotillomania were randomly assigned to receive NAC or matching placebo for 12 weeks. Our primary outcome was change in severity of hairpulling as measured by the Massachusetts General Hospital–Hairpulling Scale (MGH-HPS). Secondary measures assessed hairpulling severity, automatic versus focused pulling, clinician-rated improvement, and comorbid anxiety and depression. Outcomes were examined using linear mixed models to test the treatment×time interaction in an intention-to-treat population. Results No significant difference between N -acetylcysteine and placebo was found on any of the primary or secondary outcome measures. On several measures of hairpulling, subjects significantly improved with time regardless of treatment assignment. In the NAC group, 25% of subjects were judged as treatment responders, compared to 21% in the placebo group. Conclusions We observed no benefit of NAC for the treatment of children with trichotillomania. Our findings stand in contrast to a previous, similarly designed trial in adults with TTM, which demonstrated a very large, statistically significant benefit of NAC. Based on the differing results of NAC in pediatric and adult TTM populations, the assumption that pharmacological interventions demonstrated to be effective in adults with TTM will be as effective in children, may be inaccurate. This trial highlights the importance of referring children with TTM to appropriate behavioral therapy before initiating pharmacological interventions, as behavioral therapy has demonstrated efficacy in both children and adults with trichotillomania.
Editor: Maryland Heights, MO: Elsevier Inc
Idioma: Inglês

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N -Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial

Bloch, Michael H., M.D., M.S ; Panza, Kaitlyn E., B.A ; Grant, Jon E., J.D., M.D., Ph.D ; Pittenger, Christopher, M.D., Ph.D ; Leckman, James F., M.D

Maryland Heights, MO: Elsevier Inc

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