Christenson G A, Mackenzie T B, Mitchell J E
Department of Psychiatry, University of Minnesota, Minneapolis 55455.
Am J Psychiatry. 1991 Mar;148(3):365-70. doi: 10.1176/ajp.148.3.365.
This study was constructed to detail the demographic and phenomenological features of chronic hair pullers as well as to assess psychiatric comorbidity in a sizable study group.
Subjects were drawn from an outpatient population of chronic hair pullers who had been referred to a trichotillomania clinic or had responded to a newspaper advertisement announcing a treatment study of adults who pull out their hair. Sixty adult chronic hair pullers completed a semistructured interview that focused on their hair-pulling behavior and demographic characteristics and that incorporated screening questions for DSM-III-R axis I disorders. The data were tabulated to derive a comprehensive picture of this group.
The typical subject was a 34-year-old woman who had pulled hair from two or more sites for 21 years. All subjects described either tension before or relief/gratification after pulling hair from the primary site, but 17% (N = 10) failed to describe both of these characteristics and thus failed to fulfill the DMS-III-R criteria for trichotillomania. Forty-nine subjects (82%) qualified for past or current axis I diagnoses other than trichotillomania. Several characteristics of the study group suggested phenomenological differences between obsessive-compulsive disorder and trichotillomania.
Adult trichotillomania is a chronic disorder, frequently involving multiple hair sites, and is associated with high rates of psychiatric comorbidity. Its relation to obsessive-compulsive disorder requires further clarification. The tension-reduction requirement in DSM-III-R for the diagnosis of trichotillomania may be overly restrictive.
本研究旨在详细描述慢性拔毛者的人口统计学和现象学特征，并在一个规模较大的研究组中评估精神疾病共病情况。
研究对象来自慢性拔毛者的门诊患者，这些患者或是被转诊至拔毛癖诊所，或是对一则关于成人拔毛治疗研究的报纸广告做出了回应。60名成年慢性拔毛者完成了一项半结构化访谈，该访谈聚焦于他们的拔毛行为和人口统计学特征，并纳入了针对《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）轴I障碍的筛查问题。对数据进行列表整理，以全面了解该组情况。
典型的研究对象是一名34岁女性，她从两个或更多部位拔毛已达21年。所有研究对象都描述了在从主要部位拔毛前有紧张感，或拔毛后有放松/满足感，但17%（N = 10）的研究对象未能描述这两种特征，因此不符合DSM-III-R关于拔毛癖的诊断标准。49名研究对象（82%）符合除拔毛癖之外的既往或当前轴I诊断标准。研究组的几个特征表明强迫症和拔毛癖在现象学上存在差异。
成人拔毛癖是一种慢性疾病，常涉及多个毛发部位，且与高精神疾病共病率相关。其与强迫症的关系需要进一步阐明。DSM-III-R中拔毛癖诊断的紧张缓解要求可能过于严格。
