The Demography, Phenomenology, and Family History of 22 Persons with Compulsive Hair Pulling

Abstract

This study reports on the demographics, phenomenology, and family history of 22 compulsive hair pullers. Subjects were recruited through a psychiatric outpatient clinic as well as newspaper advertisements. Subjects completed a semistructured interview focused on hair-pulling behavior and demographics, the Diagnostic Interview Schedule to assess major (Axis I) mental disorders, and the Structured Interview for DSM-III-R Personality Disorders to assess Axis II disorders. The typical subject was a 33-year-old woman who had completed 1 or more years of college and had been pulling her hair for 19 years. Nearly two-thirds met the criteria for a major mental disorder (particularly anxiety and mood disorders), and more than one-half met the criteria for a personality disorder. Nearly three-quarters of first-degree relatives were reported to have a psychiatric disorder, and about 5% were reported to be hair pullers.

Compulsive Aspects of Impulse-Control Disorders

“…The study involved 22 subjects who had trichotillomania and 102 first-degree relatives. When compared with a control group (n = 33, with 182 first-degree relatives), significantly more relatives of the trichotillomania probands had OCD (2.9%) compared with the control group [48]. A family study of OCD probands found a higher proportion of case subjects than control subjects had trichotillomania (4% versus 1%), although the difference was not statistically significant given the sample size [18].…”

Tricotilomania

“…Christenson et al conduziram uma pesquisa com 186 pacientes com TTM e relataram que a preferência por região comprometida ficou assim distribuída: couro cabeludo (80,6%), cílios (47%), sobrancelhas (43,5%), região pú-bica (23,7%), extremidades (15,1%), axila (5,4%) e abdômen (4,3%) 11 . Essa hierarquia foi corroborada por estudos posteriores 6,12 . Pacientes relataram que o comportamento de arrancar cabelo ocasionalmente pode ocorrer em mais de uma região do corpo, simultaneamente 13 .…”

“…Situações como ler, assistir à televisão, falar ao telefone, ficar deitado na cama e dirigir automóvel aparecem com frequência nos relatos associados ao comportamento 6,12,32 . Tais atividades sedentá-rias ou contemplativas, bem como estados afetivos negativos, são frequentemente referidas como desencadeadoras ou mantenedoras do comportamento 33 .…”

“…Em outro estudo com famílias, 5% de parentes de probandos com TTM informaram apresentar, no presente ou no passado, comportamento de arrancar cabelo semelhante. Essa taxa não era estatisticamente significante em diferentes trabalhos quando comparada com grupo controle 12,79 .…”

“…Embora as pesquisas que investigam comorbidades em TTM sejam limitadas, outros transtornos psiquiátricos são mais prevalentes em grupos diagnosticados com TTM do que seria esperado ao acaso 1,12 .…”