Sociodemographic variables, clinical characteristics, and treatments in children with trichotillomania in terms of age and gender: a multicenter study

Abstract

Objective

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.

Method

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.

Results

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.

Conclusion

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.

Keywords:

• Child/adolescent
• trichotillomania
• hair pulling
• comorbidity
• psychopharmacotherapy

Acknowledgements

The authors thank all the children and their families who participated in this study.

Ethical approval

This study was approved by the local Ethics Committee of the Medical Faculty of the Kahramanmaras SutcuImam University.

Author contributions

Study conception and design: S.C.A., A.U.C., and H.D.; Collection, analysis, and interpretation of the data: S.C.A., A.U.C., and I.U.; Drafting of the manuscript: S.C.A., A.U.C., and I.U.; Critical revision: A.U.C. All authors read and approved the final manuscript.

Disclosure statement

The authors have no specific funding or other conflicts of interest to disclose.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Additional information

Notes on contributors

Semiha Comertoglu Arslan

Semiha Comertoglu Arslan received her specialty education in the Department of Child and Adolescent Psychiatry at Atatürk University. She has been working as Asst. Prof Dr. at KSU University, Faculty of Medicine. She is interested in anxiety disorders, trikotillomania, depression, autism spectrum disorders, attention deficit and hyperactivity disorder.

Ayla Uzun Cicek

Ayla Uzun Cicek received her specialty education in the Department of Child and Adolescent Psychiatry at Akdeniz University. She has been working as Assoc. Prof Dr. at Cumhuriyet University Faculty of Medicine, Department of Child and Adolescent Psychiatry. She deals with mood disorders, anxiety disorders, autism spectrum disorders, attention deficit and hyperactivity disorder.

Ilknur Ucuz

Ilknur Ucuz received her specialty education in the Department of Child and Adolescent Psychiatry at Atatürk University. She has been working as Assoc. Prof Dr. at Inonu University, Faculty of Medicine. She is interested in anxiety disorders, autism spectrum disorders, attention deficit and hyperactivity disorder, artificial intelligence, and machine learning.

Hicran Dogru

Hicran Dogru made her residency in the Department of Child and Adolescent Psychiatry, Akdeniz University. She has been working as Assistant Prof Dr. at Ataturk University Faculty of Medicine. She is interested in forensic psychiatry, autism spectrum disorders, attention-deficit/hyperactivity disorder, and behavioral therapies.