A comparison of phenomenological, clinical and familial psychiatric features of pediatric OCD and trichotillomania

Int J Psychiatry Clin Pract. 2022 Jun;26(2):139-147. doi: 10.1080/13651501.2021.1933041. Epub 2021 Jun 14.


Objectives: Although trichotillomania (TTM) is classified in the obsessive-compulsive disorders (OCD) chapter of the DSM-5, several studies showed that it has several differences. The aim of this study was to examine the phenomenology, comorbidity, and family psychiatric characteristisc of childhood TTM and OCD.

Methods: This study compared youth ages 6-17 years with a primary diagnosis of TTM (n = 63) to those with primary OCD (n = 65) on clinical and familial psychiatric characteristics.

Results: In our study, the findings showed that family history of schizophrenia (42.3%) was higher among patients with TTM than the OCD group, while the history of OCD (55.8%) in the family was significantly higher among the OCD group (p < 0.001). The behaviour of plucking eyebrows was significantly higher among patients with TTM comorbid OCD than patients with only trichotillomania. TTM patients with comorbid OCD had one-dimensional symptom distribution than the presence of the OCD-only group, and the severity of OCD was lower. The incidence of pathological doubting was higher among the TTM group with comorbid OCD, than those with only OCD diagnosis.

Conclusions: These findings support significant differences between OCD and TTM. Differences between OCD and TTM may reflect differences in underlying psychobiology, and may necessitate contrasting treatment approaches.KEYPOINTSWe aimed to compare the trichotillomania in itself and in the presence of OCD with the OCD group.Even if OCD accompanied trichotillomania, OCD symptom dimensions and severity were found to be lower than in the OCD-only group.Trichotillomania is a heterogeneous disorder with different dimensions besides the OCD spectrum.

Keywords: Trichotillomania; adolescent; children; compulsion; obsession.

MeSH terms

  • Adolescent
  • Child
  • Comorbidity
  • Compulsive Personality Disorder
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • Obsessive-Compulsive Disorder*
  • Trichotillomania*