Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study

L. J. Cohen, D. J. Stein, D. Simeon, E. Spadaccini, J. Rosen, B. Aronowitz, Eric Hollander

Research output: Contribution to journalArticle

177 Citations (Scopus)

Abstract

Background: Trichotillomania, characterized by an irresistible urge to pull one's hair, may be more prevalent than previously believed. Despite increasing attention devoted to this topic in the recent literature, there are few studies based on large samples that are potentially generalizable to a community population. Method: Surveys addressing clinical profile, comorbidity, and treatment history were mailed to all responders to a nationally distributed magazine article on trichotillomania. Out of 772 surveys sent, 123 completed surveys were returned. Results: While there was a predominance of females in the whole sample, female to male prevalence was lower in children than adults. Onset was predominantly in childhood (mean age = 11 years), most frequently in middle childhood and least frequently before age 6. Subjects pulled hair from a variety of sites, including scalp, eyelashes, eyebrows, pubic region, face, and body, but the highest incidence and severity involved scalp hair. Children under 6 were more likely than other age groups to pull scalp hair and possibly less likely to pull other hair. In adults, symptom profile was not associated with age at onset. While subjects reported high rates of comorbid conditions in both self and family, trichotillomania was reportedly formally diagnosed in only 40% of the subjects. Although subjects reported a range of treatments, the majority (58%) reported no treatment history. Finally, only minimal improvement was reported for all modalities, with no significant difference in response to psychotherapy, behavior therapy, clomipramine, or fluoxetine. Conclusion: Trichotillomania is a chronic illness that may be difficult to treat. Controlled studies on comorbidity, epidemiology, treatment-seeking patterns, and long-term treatment response are needed.

Original languageEnglish (US)
Pages (from-to)319-326
Number of pages8
JournalJournal of Clinical Psychiatry
Volume56
Issue number7
StatePublished - 1995
Externally publishedYes

Fingerprint

Trichotillomania
Hair
Comorbidity
History
Scalp
Eyelashes
Eyebrows
Therapeutics
Clomipramine
Body Regions
Behavior Therapy
Fluoxetine
Age of Onset
Psychotherapy
Epidemiology
Chronic Disease
Age Groups
Surveys and Questionnaires
Incidence
Population

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Cohen, L. J., Stein, D. J., Simeon, D., Spadaccini, E., Rosen, J., Aronowitz, B., & Hollander, E. (1995). Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study. Journal of Clinical Psychiatry, 56(7), 319-326.

Clinical profile, comorbidity, and treatment history in 123 hair pullers : A survey study. / Cohen, L. J.; Stein, D. J.; Simeon, D.; Spadaccini, E.; Rosen, J.; Aronowitz, B.; Hollander, Eric.

In: Journal of Clinical Psychiatry, Vol. 56, No. 7, 1995, p. 319-326.

Research output: Contribution to journalArticle

Cohen, LJ, Stein, DJ, Simeon, D, Spadaccini, E, Rosen, J, Aronowitz, B & Hollander, E 1995, 'Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study', Journal of Clinical Psychiatry, vol. 56, no. 7, pp. 319-326.
Cohen LJ, Stein DJ, Simeon D, Spadaccini E, Rosen J, Aronowitz B et al. Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study. Journal of Clinical Psychiatry. 1995;56(7):319-326.
Cohen, L. J. ; Stein, D. J. ; Simeon, D. ; Spadaccini, E. ; Rosen, J. ; Aronowitz, B. ; Hollander, Eric. / Clinical profile, comorbidity, and treatment history in 123 hair pullers : A survey study. In: Journal of Clinical Psychiatry. 1995 ; Vol. 56, No. 7. pp. 319-326.
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