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J Nerv Ment Dis. 2010 Dec;198(12):896-900. doi: 10.1097/NMD.0b013e3181fe7423.

Age of onset of trichotillomania symptoms: investigating clinical correlates.

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  • 1Bradley Hasbro Children's Research Center, Providence, RI, USA.


Pathological hair-pulling with onset in very early childhood is thought to represent a different disorder from that with later onset. We examined whether there are differences between adult hair-pullers with very early onset (VEO, i.e., <6 years), early onset (EO, i.e., 6 years to <18 years), and late onset (LO, i.e., ≥18 years) trichotillomania symptomatology. Participants with VEO (n = 76; 5%), EO (n = 1280; 80%), and LO (n = 248; 15%) symptoms of trichotillomania did not differ significantly from one another in terms of hair-pulling phenomenologies, comorbidity, functional impact, and perceived treatment response. However, hair-pulling sites varied across the groups; the VEO and EO groups were significantly more likely to pull eyelashes whereas the EO group was more likely to pull pubic hair. Study subjects had current hair-pulling, so biasing the sample to those with more enduring symptoms, despite differences in age of onset of initial pulling. The lack of significant differences found here does not support subtyping hair-pulling by age of onset in patients who present in adulthood.

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