Skip to main content
SpringerLink
Log in

Trichotillomania and related disorders in children and adolescents

  • Articles
  • Published:
Child Psychiatry and Human Development Aims and scope Submit manuscript

Abstract

Eleven chronic hair pullers, 11 subjects with obsessive-compulsive disorder (OCD), and 11 subjects with a non-OCD anxiety disorder were assessed with structured interviews and the Child Behavior Checklist (CBCL). Only 4 hair pullers (36%) reported both rising tension and relief with hair pulling. Each group had significantly more internalizing than externalizing symptoms on the CBCL. Seven hair pullers (64%) had a lifetime history of at least one other axis I diagnosis. The results provide further evidence that trichotillomania in referred children and adolescents is usually a chronic disorder often associated with internalizing symptoms and psychiatric comorbidity. Rising tension followed by relief with hair pulling may be an unnecessary restriction in the diagnosis of childhood trichotillomania.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, D. C.: American Psychiatric Association, 1994.

    Google Scholar 

  2. Christenson GA, Mackenzie TA, Mitchell JE: Characteristics of 60 adult hair pullers.Am J Psychiatry 148, 365–370, 1991.

    PubMed  Google Scholar 

  3. Cohen LJ, Stein DJ, Simeon D, Spadaccini E, Rosen J, Aronowitz B, Hollander E: Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study.J Clin Psychiatry 56, 319–326, 1995.

    PubMed  Google Scholar 

  4. King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A, Cohen DJ, Pauls DL, Apter A: An epidemiological study of trichotillomania in Israeli adolescents.J Am Acad Child Adolesc Psychiatry 34, 1212–1215, 1995.

    PubMed  Google Scholar 

  5. Christenson GA, Pyle RL, Mitchell JE: Estimated lifetime prevalence of trichotillomania in college students.J Clin Psychiatry 52, 415–417, 1991.

    PubMed  Google Scholar 

  6. Rothbaum BO, Shaw L, Morris R, Ninan PT: Prevalence of trichotillomania in a college freshman population (letter).J Clin Psychiatry 54, 72, 1993.

    PubMed  Google Scholar 

  7. Oranje AP, Peereboom-Wynia JD, DeRaeymacker DM: Trichotillomania in childhood.J Am Acad Dematology 15, 614–619, 1986.

    Google Scholar 

  8. Delgado RA, Mannino FV: Some observations on trichotillomania in children.J Am Acad Child Psychiatry 8, 229–246, 1969.

    PubMed  Google Scholar 

  9. Greenberg HR, Sarner CA: Trichotillomania: Symptom and syndrome.Arch Gen Psychiatry 12, 482–489, 1965.

    PubMed  Google Scholar 

  10. Christenson GA, Popkin MK, Mackenzie TB, Realmuto GM: Lithium treatment of chronic hair pulling.J Clin Psychiatry 52, 116–120, 1991.

    PubMed  Google Scholar 

  11. McElroy SL, Hudson JI, Pope HG, Keck PE, Aizley HG: The DSM-III-R impulse control disorder not elsewhere classified: Clinical characteristics and relationship to other psychiatric disorders.Am J Psychiatry 149, 318–327, 1992.

    PubMed  Google Scholar 

  12. Swedo SE, Leonard HL, Rapoport JL, Lenane MC, Goldberger EL, Cheslow DL: A double blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling).N Engl J Med 321, 497–501, 1989.

    PubMed  Google Scholar 

  13. Jenicke MA: Obsessive-compulsive disorder and related disorders: A hidden epidemic.N Engl J Med 321:539–541, 1989.

    Google Scholar 

  14. McElroy SL, Hudson JI, Phillips KA, Keck PE, Pope HG: Clinical and theoretical implications of a possible link between obsessive-compulsive and impulse control disorders.Depression 1, 121–132, 1993.

    Google Scholar 

  15. Swedo SE, Leonard HL: Trichotillomania: An obsessive compulsive disorder?Psychiatric Clinics N Am 15:777–790, 1992.

    Google Scholar 

  16. Christenson GA, Mackenzie TA, Mitchell JE, Callies A: A placebo controlled double blind crossover study of fluoxetine in trichotillomania.Am J Psychiatry 148, 1566–1571, 1991.

    PubMed  Google Scholar 

  17. Himle JA, Bordnick PS, Thyer BA: A comparison of trichotillomania and obsessive-compulsive disorder.J Psychopathology Behav Assess 17:251–260, 1995.

    Google Scholar 

  18. King RA, Scahill L, Vitulano LA, Schwab-Stone M, Tercyak KP Jr, Riddle MA: Childhood trichotillomania: Clinical phenomenology, comorbidity, and family genetics.J Am Acad Child Adolesc Psychiatry 34, 1451–1459, 1995.

    PubMed  Google Scholar 

  19. Reeve EA, Bernstein GA, Christenson GA: Clinical characteristics and psychiatric comorbidity in children with trichotillomania.J Am Acad Child Adolesc Psychiatry 31:132–138, 1992.

    PubMed  Google Scholar 

  20. Stanley MA, Swann AC, Bowers TC, Davis ML, Taylor DJ: A comparison of clinical features in trichotillomania and obsessive-compulsive disorder.Behav Res Ther 30, 39–44, 1992.

    Article  PubMed  Google Scholar 

  21. Swedo SE, Rapoport JL, Leonard HL, Schapiro MB, Rapoport SI, Grady CL: Regional cerebral glucose metabolism of women with trichotillomania.Arch Gen Psychiatry 48, 828–833, 1991.

    PubMed  Google Scholar 

  22. Streichenwein SM, Thornby JI: A long-term, double-blind, placebo-controlled crossover trial of the efficacy of fluoxetine for trichotillomania.Am J Psychiatry 152, 1192–1196, 1995.

    PubMed  Google Scholar 

  23. Winchel RM, Jones JS, Stanley B, Molcho A, Stanley M: Clinical characteristics of trichotillomania and its response to fluoxetine.J Clin Psychiatry, 53, 304–308, 1992.

    PubMed  Google Scholar 

  24. American Psychiatric Association,Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Washington, D. C.: American Psychiatric Association, 1987.

    Google Scholar 

  25. Kovacs M:Children's Depression Inventory. North Tonawands, NY: Multi-Health Systems, Inc., 1992.

    Google Scholar 

  26. Shaywitz SE, Shaywitz BA, Schnell C, Towle VR: Concurrent and predictive validity of the Yale Children's Inventory: An instrument to assess children with attentional deficits and learning disabilities.Pediatrics 81, 562–571, 1988.

    PubMed  Google Scholar 

  27. Achenbach TM:Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry, 1991.

    Google Scholar 

  28. Hollingshead AB:Two-Factor Index of Social Position. New Haven, CT: Yale University Department of Sociology, 1965.

    Google Scholar 

  29. Welner Z, Reich W, Herjanic B, Jung K, Amado H: Rehability, validity and child agreement studies of the Diagnostic Interview for Children and Adolescents (DICA).J Am Acad Child Adolesc Psychiatry 26, 649–653, 1987.

    PubMed  Google Scholar 

  30. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The Yale-Brown Obsessive Compulsive Scale I. Development, use, and reliability.Arch Gen Psychiatry 46, 1006–1011, 1989.

    PubMed  Google Scholar 

  31. Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS: The Yale-Brown Obsessive Compulsive Scale II. validity.Arch Gen Psychiatry 46, 1012–1016, 1989.

    PubMed  Google Scholar 

  32. Dunn OJ: Multiple comparison among means.J Am Stat Assoc 56, 52–64, 1961.

    Google Scholar 

  33. Berkson J: Limitations of the application of fourfold table analysis to hospital data.Biometrics Bull 2, 47–53, 1946.

    Google Scholar 

  34. Christenson GA, MacKenzie TB, Mitchell JE: Adult men and women with trichotillomania.Psychosomatics 35, 142–149, 1994.

    PubMed  Google Scholar 

  35. Greenberg HR, Sarner CA: Trichotillomania: Symptom and syndrome.Arch Gen Psychiatry 12, 482–489, 1965.

    PubMed  Google Scholar 

  36. Muller SA: Trichotillomania: A histopathologic study in sixty-six patients.J Am Acad Dermatol 23, 56–62, 1990.

    PubMed  Google Scholar 

  37. Friman PC, Rostain A: Trichotillomania (hair pulling).N Engl J Med 332:471, 1990.

    Google Scholar 

  38. Friman PC, Blum NH, Rostain A: Is hair pulling benign?J Am Acad Child Adolesc Psychiatry 31, 991–992, 1992.

    PubMed  Google Scholar 

  39. Swedo SE, Rapoport JL: Annotation: Trichotillomania.J Child Psychol Psychiatry 32:401–409, 1991.

    PubMed  Google Scholar 

  40. Kovacs M, Feinberg TL, Crouse-Novak MA, Paulauskas SL, Pollock M, Finkelstein R: Depressive disorders in childhood: I. A longitudinal study of the risk for a subsequent major depression.Arch Gen Psychiatry 41, 643–649, 1984.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Child and Adolescent Psychiatric Hospital, University of Michigan Medical Center, 1500 East Medical Center Drive, 48109-0390, Ann Arbor, MI

    Gregory L. Hanna MD

Authors
  1. Gregory L. Hanna MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hanna, G.L. Trichotillomania and related disorders in children and adolescents. Child Psych Hum Dev 27, 255–268 (1997). https://doi.org/10.1007/BF02353354

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02353354

Key Words

Search

Navigation