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Trichotillomania—psychopathological correlates and associations with health-related quality of life in a large sample

Published online by Cambridge University Press:  08 April 2020

Andre P. Bezerra ,
Myrela O. Machado ,
Michel Maes Open the ORCID record for Michel Maes [Opens in a new window] ,
Donatella Marazziti Open the ORCID record for Donatella Marazziti [Opens in a new window] ,
Paulo R. Nunes-Neto ,
Marco Solmi ,
Joseph Firth ,
M. Ishrat Husain ,
Andre R. Brunoni  and
Paul Kurdyak
...Show all authors
Andre P. Bezerra
Affiliation:
Unichristus Medical School, Fortaleza, Brazil
Myrela O. Machado
Affiliation:
Division of Dermatology, Women’s College Hospital, Toronto, Ontario, Canada
Michel Maes
Affiliation:
Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
Donatella Marazziti
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Paulo R. Nunes-Neto
Affiliation:
Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Brazil
Marco Solmi
Affiliation:
Department of Neurosciences, University of Padova, Padova, Italy Padova Neuroscience Center, University of Padua, Padua, Italy
Joseph Firth
Affiliation:
NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
M. Ishrat Husain
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
Andre R. Brunoni
Affiliation:
Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27) National Institute of Biomarkers in Neuropsychiatry (INBioN), Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil National Institute of Biomarkers in Neuropsychiatry (INBioN), Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil Department of Clinical Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
Paul Kurdyak
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
Lee Smith
Affiliation:
Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
Afsaneh Alavi
Affiliation:
Division of Dermatology, Women’s College Hospital, Toronto, Ontario, Canada Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada
Vincent Piguet
Affiliation:
Division of Dermatology, Women’s College Hospital, Toronto, Ontario, Canada Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
André F. Carvalho*
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
*
Author for correspondence: Andre F. Carvalho, MD Email: andre.carvalho@camh.ca; andrefc7@hotmail.com
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Abstract

Background

Relatively few studies have assessed the prevalence, correlates, and independent impact on quality of life (QoL) of trichotillomania (TTM) in large samples.

Methods

Consecutive participants (N = 7639) were recruited from a cross-sectional web-based study. Sociodemographic data were collected and several validated self-reported mental health measures were completed (Minnesota Impulsive Disorders Interview, Hypomania checklist, Fagerström Test for Nicotine Dependence, Alcohol Use Disorders Identification Test, Early Trauma Inventory Self Report–Short Form, and the Symptom Checklist-90–Revised Inventory). Health-related QoL was assessed with the World Health Organization QoL abbreviated scale (WHOQOL-Bref). Multivariable models adjusted associations to potential confounders.

Results

The sample was predominantly composed of young females (71.3%; mean age: 27.2 ± 7.9 years). The prevalence of probable TTM was 1.4% (95% confidence intervals [CI]: 1.2-1.7), and was more common among females. Participants with probable TTM had a greater likelihood of having co-occurring probable depression (adjusted odds ratio [ORadj] = 1.744; 95% CI: 1.187-2.560), tobacco (ORadj = 2.250; 95% CI: 1.191-4.250), and alcohol (ORadj = 1.751; 95% CI: 1.169-2.621) use disorders. Probable TTM was also independently associated with suicidal ideation (ORadj = 1.917; 95% CI: 1.224-3.003) and exposure to childhood sexual abuse (ORadj = 1.221; 95% CI: 1.098-1.358). In addition, a positive screen for TTM had more impaired physical and mental QoL.

Conclusions

TTM was associated with a positive screen for several psychiatric comorbidities as well as impaired physical and psychological QoL. Efforts towards the recognition and treatment of TTM across psycho-dermatology services are warranted.

Keywords

Trichotillomaniabehavioral addictionsquality of lifecomorbiditiespsychiatry
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 3 , June 2021 , pp. 282 - 289
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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Footnotes

Andre P. Bezerra and Myrela O. Machado contributed equally to this manuscript.

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