Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcuımam University, Kahramanmaras, Turkey.
Department of Child and Adolescent Psychiatry, Cumhuriyet University, Sivas, Turkey.
Nord J Psychiatry. 2023 Jan;77(1):36-45. doi: 10.1080/08039488.2022.2052179. Epub 2022 Mar 30.
Although trichotillomania (TTM) is a common, typically pediatric-onset disorder, data on the phenomenology of TTM in children, accompanying comorbid psychiatric disorders, and treatment options are extremely limited. In our study, it was aimed to investigate these variables and related factors in patients undergoing psychiatric evaluation and follow-up.
The study included 79 children and adolescents between the ages of 4 and 17 who were diagnosed with TTM and followed up in four different Child and Adolescent Psychiatry outpatient clinics between 2015 and 2020. The sociodemographic characteristics of these patients, clinical features of the disease, comorbid psychiatric disorders, and treatment approaches have been studied.
Our results showed that TTM was more common in girls, hair and eyebrow plucking was the most common, and symptoms and features accompanying TTM changed with age, but not with gender. Again, 79.7% of these children had at least one psychiatric comorbid disorder (most common being anxiety disorders and Attention Deficit/Hyperactivity Disorder), comorbidity was closely related to TTM severity, 93.7% used at least one pharmacotherapeutic agent, and positive response rates to treatment were found to be low. Moreover, TTM severity was found to increase with age and disease duration.
Study findings support that clinical presentation, disease severity and comorbidity rates may change with age in children and adolescents with TTM, and early intervention is important to prevent clinical progression/worsening and mental health sequela.
尽管拔毛癖(TTM)是一种常见的、通常在儿童期发病的疾病,但有关儿童 TTM 的现象学、伴随的共患精神障碍以及治疗选择的数据极为有限。在我们的研究中,旨在调查接受精神科评估和随访的患者的这些变量和相关因素。
该研究纳入了 2015 年至 2020 年间在四个不同的儿童和青少年精神病学门诊被诊断为 TTM 并接受随访的 79 名 4 至 17 岁的儿童和青少年。研究了这些患者的社会人口学特征、疾病的临床特征、共患精神障碍和治疗方法。
我们的结果表明,TTM 在女孩中更为常见,最常见的是拔头发和眉毛,且症状和伴随 TTM 的特征随年龄而变化,但不受性别影响。同样,这些儿童中有 79.7%至少有一种精神共患障碍(最常见的是焦虑障碍和注意缺陷多动障碍),共病与 TTM 严重程度密切相关,93.7%使用了至少一种药物治疗药物,治疗的有效率较低。此外,TTM 的严重程度随年龄和疾病持续时间的增加而增加。
研究结果支持这样的观点,即儿童和青少年 TTM 的临床表现、疾病严重程度和共病率可能随年龄而变化,早期干预对于预防临床进展/恶化和心理健康后遗症很重要。