Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States.
Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States; Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
Psychiatry Res. 2023 Apr;322:115120. doi: 10.1016/j.psychres.2023.115120. Epub 2023 Feb 21.
Trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder are body-focused repetitive behaviors, which often first present in adolescence and cause distress and impairment into adulthood. Few studies have examined the clinical characteristics of the co-occurrence of these conditions across the lifespan. We examined cross-sectional survey responses collected from April 2018-February 2020 to evaluate the relationship between trichotillomania, excoriation disorder, and their co-occurrence. Responses from individuals with trichotillomania (n = 50), excoriation disorder (n = 52), and both conditions (n = 50) ages 4-67 years old were compared for co-occurring conditions and current symptoms. Self-report measures of hair-pulling and skin-picking severity and subtypes were assessed. Gender, race, and co-occurring conditions were generally similarly distributed across the three groups with high rates of self-reported anxiety (63-82%), depression (34-50%), obsessive-compulsive disorder (16-29%), and attention-deficit/hyperactivity disorder (12-32%). Among individuals with both trichotillomania and excoriation disorder, significant positive correlations were observed between hair-pulling and skin-picking severity scores as well as hair-pulling and skin-picking subtypes. Hair-pulling and skin-picking severity peaked at the transition from adolescence to adulthood and hair-pulling/skin-picking styles appeared to shift across the lifespan. Our results support several similarities between trichotillomania and excoriation disorder, providing new insight into the clinical characteristics of these conditions.
拔毛癖（毛发 pulling 障碍）和抓挠（皮肤 picking 障碍）是两种以身体为焦点的重复性行为，通常在青少年时期首次出现，并导致成年后出现痛苦和障碍。很少有研究检查这些条件在整个生命周期中同时出现的临床特征。我们检查了 2018 年 4 月至 2020 年 2 月期间收集的横断面调查回复，以评估拔毛癖、抓挠障碍及其共存之间的关系。对年龄在 4 至 67 岁之间患有拔毛癖（n=50）、抓挠障碍（n=52）和两种疾病（n=50）的个体的回复进行了比较，以评估共存疾病和当前症状。评估了毛发 pulling 和皮肤 picking 严重程度和亚型的自我报告测量。性别、种族和共存疾病在三组之间的分布大致相同，报告的焦虑症（63-82%）、抑郁症（34-50%）、强迫症（16-29%）和注意缺陷多动障碍（12-32%）发生率较高。在同时患有拔毛癖和抓挠障碍的个体中，毛发 pulling 和皮肤 picking 严重程度评分以及毛发 pulling 和皮肤 picking 亚型之间存在显著正相关。毛发 pulling 和皮肤 picking 的严重程度在从青春期到成年期的过渡期间达到高峰，毛发 pulling/skin-picking 风格似乎在整个生命周期中发生变化。我们的结果支持拔毛癖和抓挠障碍之间的几个相似之处，为这些疾病的临床特征提供了新的见解。
