Rapunzel syndrome is not just a mere surgical problem: A case report and review of current management

Table 1 Management of cases of recurrent Rapunzel syndrome in the literature¹

Ref.	Year published	Age (S1)	Psychiatric management	Age (S2)	Psychiatric management	Interval (recurrence)	Reason for recurrence
Memon et al[2]	2003	10	Advised treatment of her emotional disturbances	12	Supervised psychiatric treatment2	2 yr	Unresolved emotional stress factor (ignored psychiatric treatment, continued to eat hairs of females neighbours)
Eryilmaz et al[23]	2004	12	Psychiatric treatment2	19	Supervised treatment with family counselling	7 yr	Underlying depressive personality disorder
Morales-Fuentes et al[22]	2010	16	No treatment mentioned	22	Psychiatric treatment2	6 yr	Inadequate initial treatment Obsessive disorder Pleasure feeling of how the hair scrapped the throat
Jones et al[6]	2010	35	No treatment mentioned	37	Quetiapine Habit reversal training with family and neighbours involvement	2 yr	Inadequate initial treatment
Tiwary et al[18]	2011	10	Behavioural therapy Clomipramine after 1 mo Follow-up × 6/12	15	Supervised psychiatric treatment2	5 yr	Lack of psych follow-up Defaulted after 6/12
Current study	2016	16	Behavioural therapy	25	Supervised behavioural therapy Quetiapine 25 mg	9 yr	Defaulted follow-up due to stressors at home

¹All cases involved female patients;

²Details not specified. S1: First surgical intervention; S2: Second surgical intervention.