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Clin Psychol Rev. 2012 Nov;32(7):618-29. doi: 10.1016/j.cpr.2012.05.008. Epub 2012 Jul 20.

How related are hair pulling disorder (trichotillomania) and skin picking disorder? A review of evidence for comorbidity, similarities and shared etiology.

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Department of Psychology, University of Wisconsin-Milwaukee, Garland Hall, 2441 Harford Avenue, Milwaukee, WI 53201, USA.


Hair pulling disorder (HPD; trichotillomania) and skin picking disorder (SPD) are relatively common and potentially severe psychiatric conditions that have received limited empirical attention. Researchers are increasingly recognizing the similarities and co-occurrence of HPD and SPD, and several authors have suggested that the two disorders should be categorized together in the DSM-5. In the present article, we critically examined the evidence for comorbidity of HPD and SPD, and reviewed a diverse literature pertaining to shared risk factors and similarities in clinical characteristics. Evidence suggests that the two disorders co-occur more often than can be expected by chance, have substantial similarities in a variety of clinical characteristics (e.g., symptom presentation and course of illness) and may have some distal risk factors in common (e.g., genetic vulnerabilities). Implications for classification in the DSM-5, clinical management and research on etiology were discussed.

[Indexed for MEDLINE]

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