Flessner Christopher A, Lochner Christine, Stein Dan J, Woods Douglas W, Franklin Martin E, Keuthen Nancy J
Bradley Hasbro Children's Research Center, Providence, RI, USA.
J Nerv Ment Dis. 2010 Dec;198(12):896-900. doi: 10.1097/NMD.0b013e3181fe7423.
Pathological hair-pulling with onset in very early childhood is thought to represent a different disorder from that with later onset. We examined whether there are differences between adult hair-pullers with very early onset (VEO, i.e., <6 years), early onset (EO, i.e., 6 years to <18 years), and late onset (LO, i.e., ≥18 years) trichotillomania symptomatology. Participants with VEO (n = 76; 5%), EO (n = 1280; 80%), and LO (n = 248; 15%) symptoms of trichotillomania did not differ significantly from one another in terms of hair-pulling phenomenologies, comorbidity, functional impact, and perceived treatment response. However, hair-pulling sites varied across the groups; the VEO and EO groups were significantly more likely to pull eyelashes whereas the EO group was more likely to pull pubic hair. Study subjects had current hair-pulling, so biasing the sample to those with more enduring symptoms, despite differences in age of onset of initial pulling. The lack of significant differences found here does not support subtyping hair-pulling by age of onset in patients who present in adulthood.
在幼儿期就开始的病理性拔毛被认为与发病较晚的情况代表不同的疾病。我们研究了成年拔毛者中，发病极早（VEO，即<6岁）、发病早（EO，即6岁至<18岁）和发病晚（LO，即≥18岁）的拔毛癖症状学之间是否存在差异。有拔毛癖症状的VEO组（n = 76；5%）、EO组（n = 1280；80%）和LO组（n = 248；15%）在拔毛现象、共病情况、功能影响和感知的治疗反应方面彼此之间没有显著差异。然而，各组的拔毛部位有所不同；VEO组和EO组拔睫毛的可能性显著更高，而EO组拔阴毛的可能性更高。研究对象目前存在拔毛行为，因此尽管最初拔毛的发病年龄不同，但样本偏向于那些症状持续时间更长的人。这里发现的缺乏显著差异并不支持在成年患者中按发病年龄对拔毛进行亚型分类。
