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Trichotillomania is a disorder characterised by inability to control over pulling own hair from various parts of a body resulting in noticeable hair loss. Due to its long-term, progressive course, untreated trichotillomania can lead to disturbances in the functioning of patients and complications which are dangerous to life and health. Due to the ambiguous nature of the symptoms, they often remain unrecognised by clinicians. Most patients are afraid of revealing symptoms and reluctantly seek for professional help. In our opinion, it is necessary to increase the awareness of the disorder of physicians of different specialties to improve the detection, treatment efficacy and to prevent dangerous complications of trichotillomania. This paper summarises the current state of knowledge on the epidemiology, aetiology, clinical presentation, and treatment of trichotillomania. It is also an attempt to create guidelines in all cases of suspected trichotillomania - adapted to Polish conditions. It also highlights the importance of a multidisciplinary treatment as a condition of effectiveness of the therapy and prevention of relapse.

Objectives: The undertaken research aimed at determining the frequency of deliberate self-injurious behaviour (D-SIB) among the students of secondary schools and also the analysis of the frequency of repeated Non-Suicidal Self-Injury (NSSI) occurrences in accordance with DSM-5 criteria in reference to the age and sex in the studied population., Methods: The data was collected via survey method according to the questionnaire prepared in compliance with the criteria DSM-5 and Self-Harm Inventory. The study included randomly selected students: 1193 boys and 1027 girls in Bialystok aged 12 and 19 (average age ± SD:16.8 ± 1.65). Statistical analysis of the data was carried out using the application Statistica 10.0 PL, StatSoft., Results: These results indicate that D-SIB and NSSI affect both sexes. In the studied group 8.3 % of students engage in deliberate self-injurious behaviour. The percentage of NSSI was 4.8% (6.3% in the group of boys, 3.2 % among girls; p(Chi2)=0.01). Self-cutting was most common among 15-year-old pupils ((D-SIB:14.75%; NNSI:8.1%). The majority of respondents (82% of girls and 74% of boys) revealed that as a result of self-injury behaviour they experience relief., Conclusions: Conducting further research in the area of NSSI seems to be crucial due to chronicity and prevalence as well as the fact that numerous repeated self-injuries bringing relief or causing positive state of mind might indicate a mechanism similar to an addiction syndrome in adolescence.

Aim: The aim of this study was to observe autoagressive behaviour with patients suffering from type 1 diabetes hospitalized in The Child Psychiatry Department of The Paediatric Centre in Sosnowiec., Method: Analysis of clinical cases, medical documentation and literature., Results: Patients suffered from type 1 diabetes. On account of mental disorders they required treatment in a psychiatric ward. In the course of their hospitalization the appearance of various autoagressive behaviour were observed--the sick deliberately gave a dose of insulin improperly, apply an inadequate diet, and also self-mutilated themselves., Conclusions: Described patients by their own illness (type 1 diabetes) in a self-destructive way coped with negative emotions. Autoagressive behaviour were their way of coping with stress, communicating experienced problems to others, they also helped in reducing inner tension. Through autoagression patients express anger, guilt, shame, loneliness, inner emptiness, a lack of confidence or humiliation. The period of adolescence, female gender and the presence of chronic disease are the factors that could intensify the difficulties described.

Mental disorders are the most frequent cause of self induced injuries (self-injury). Self-mutilation is a form of auto-aggression, which is a manifestation of psychic discomfort. Skin changes, defined as self-induced skin diseases, constitute the secondary problem, and require patients to consult dermatologists. Self-induced skin diseases include Münchhausen syndrome, acne excoriée, trichotillomania, nail biting (onychophagia), dermatitis artefacta, neurotic self-mutilation, self-mutilation when associated with hallucinations and delusions. A knowledge of psycho-dermatological issues among dermatologists, general practitioners, psychiatrists and psychologists facilitates proper diagnosis and the appropriate choice and form of treatment and enables patients to be provided with more complex medical care.

Onychophagy is classified to the nail diseases caused by repeated injures. Nail-biting as autodestruction and onychophagy in its most aggressive form, is common not only among children but adults as well. Nail-biting in children belongs to the group of habits and habitual function, which allowed for relieving the anxiety, loneliness, inactivity in children deprived of safety feeling, love and nearest relationship. In most adults suffering from onychophagy psychiatric diseases are not diagnosed. There are different clinical symptoms of onychophagy depended on the degree and the way of performed injures. In this study we are promoting the multidisciplinary approach to the therapy of habitual nail-biting.