The DOI matches its Crossref record; 57 of the 57 references it cites were found in a registry or an index.
Trichotillomania
Open accessAbstract
Trichotillomania, characterized by the repetitive pulling out of one’s own hair leading to hair loss and functional impairment, has been documented in the medical literature since the 19(th) century, but has received scant research attention. Community prevalence studies suggest that trichotillomania is a common disorder with point prevalence estimate of 0.5% to 2.0%. Although recently grouped with OCD in the DSM-5, clinicians need to be aware that trichotillomania and OCD may have less in common than originally thought. In fact, approaches to treating trichotillomania, which include habit reversal therapy and medication (n-acetyl cysteine or olanzapine), are quite different from those used to treat OCD; and some first-line treatments used for OCD appear ineffective for trichotillomania. Based on our clinical experience and research findings, the article recommends several management approaches to trichotillomania.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The most common sites pulled include the scalp, eyebrows, and eyelashes; although, pulling from other areas of the body is common.[11]”
From Trichotillomania (hair pulling disorder) (2019) · cites this paper as [11]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Pulling from multiple sites is not uncommon and pulling episodes can last from a few minutes to several hours.[11]”
From Trichotillomania (hair pulling disorder) (2019) · cites this paper as [11]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The onset of hair pulling is generally in late childhood or early adolescence.[11]”
From Trichotillomania (hair pulling disorder) (2019) · cites this paper as [11]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110048007 · Cited by 7,712
The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010) · Molecular Psychiatry · doi:10.1038/mp.2008.94 · Cited by 2,771
The Epidemiology of Obsessive-Compulsive Disorder in Five US Communities
Karno, M. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800360042006 · Cited by 1,340
Cortico-striatal synaptic defects and OCD-like behaviours in Sapap3-mutant mice
Welch, J. M., Lu, J., Rodriguiz, R. M., Trotta, N. C., Peca, J., Ding, J.-D., Feliciano, C., Chen, M., Adams, J. P., Luo, J., et al. (2007) · Nature · doi:10.1038/nature06104 · Cited by 852
Characteristics of 60 adult chronic hair pullers
(1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.3.365 · Cited by 570 · cited 2×
“trichotillomania and should be screened for; comorbidity is the norm rather than the exception (32).”
BackgroundBienvenu, O., Samuels, J., Riddle, M., Hoehn-Saric, R., Liang, K.-Y., Cullen, B., Grados, M., & Nestadt, G. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00831-3 · Cited by 486
Grant, J. E., Odlaug, B. L., & Won Kim, S. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.60 · Cited by 424
Self-citationHoxb8 Is Required for Normal Grooming Behavior in Mice
Greer, J. M., & Capecchi, M. R. (2002) · Neuron · doi:10.1016/s0896-6273(01)00564-5 · Cited by 401 · cited 1×
“Markedly elevated grooming is exhibited in three models in particular: the Hoxb8 knockout mouse (34), the Sapap3 knockout mouse (35), and the Slitrk5 knockout mouse (36).”
Background(1991) · PubMed · Cited by 398
Shmelkov, S. V., Hormigo, A., Jing, D., Proenca, C. C., Bath, K. G., Milde, T., Shmelkov, E., Kushner, J. S., Baljevic, M., Dincheva, I., et al. (2010) · Nature Medicine · doi:10.1038/nm.2125 · Cited by 361
Woods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R. D., Stein, D. J., Walther, M. R., & Trichotillomania Learning Center-Scientific Advisory Board (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1207 · Cited by 317 · cited 9×
“This characteristic age at onset appears to be consistent across different cultural settings (2, 13).”
BackgroundMethodInfluentialSystematic Review: Pharmacological and Behavioral Treatment for Trichotillomania
Bloch, M. H., Landeros-Weisenberger, A., Dombrowski, P., Kelmendi, B., Wegner, R., Nudel, J., Pittenger, C., Leckman, J. F., & Coric, V. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.05.019 · Cited by 280 · cited 2×
“Treatment approaches alsodiffer: exposure and response prevention is used for OCD and habit reversal for trichotillomania, and selective serotonin reuptake inhibitors (SSRIs) show efficacy in the treatment of OCD but not, generally, in trichotillomania (28).”
Clinical profile, comorbidity, and treatment history in 123 hair pullers: a survey study.
Cohen, L. J., Stein, D. J., Simeon, D., Spadaccini, E., Rosen, J., Aronowitz, B., & Hollander, E. (1995) · PubMed · Cited by 230
Trichotillomania: An Obsessive Compulsive Spectrum Disorder?
Swedo, S. E., & Leonard, H. L. (1992) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(18)30208-9 · Cited by 218
Trichotillomania: A current review
Duke, D. C., Keeley, M. L., Geffken, G. R., & Storch, E. A. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.10.008 · Cited by 214
Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study
Bienvenu, O. J., Wang, Y., Shugart, Y. Y., Welch, J. M., Grados, M. A., Fyer, A. J., Rauch, S. L., McCracken, J. T., Rasmussen, S. A., Murphy, D. L., et al. (2009) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30897 · Cited by 207
The Demography, Phenomenology, and Family History of 22 Persons with Compulsive Hair Pulling
Schlosser, S., Black, D., Blum, N., & Goldstein, R. (1994) · Annals of Clinical Psychiatry · doi:10.3109/10401239409148996 · Cited by 178
O'Sullivan, R. L., Rauch, S. L., Breiter, H. C., Grachev, I. D., Baer, L., Kennedy, D. N., Keuthen, N. J., Savage, C. R., Manzo, P. A., Caviness, V. S., et al. (1997) · Biological Psychiatry · doi:10.1016/s0006-3223(96)00297-1 · Cited by 169
Emotion regulation and other psychological models for body-focused repetitive behaviors.
Roberts, S., O'Connor, K., & Bélanger, C. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.05.004 · Cited by 169
Trichotillomania: impact on psychosocial functioning and quality of life
Diefenbach, G. J., Tolin, D. F., Hannan, S. E., Crocetto, J., & Worhunsky, P. D. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.06.010 · Cited by 167
Grant, J. E. (2014) · New England Journal of Medicine · doi:10.1056/nejmcp1402176 · Cited by 148
Self-citationAmeringen, M. V., Mancini, C., Patterson, B. A., Bennett, M., & Oakman, J. M. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05114gre · Cited by 145
Characteristics and phenomenology of hair-pulling: an exploration of subtypes.
du Toit, P., van Kradenburg, J., Niehaus, D., & Stein, D. J. (2001) · Comprehensive Psychiatry · doi:10.1053/comp.2001.23134 · Cited by 138
Torresan, R. C., Ramos‐Cerqueira, A. T. D. A., Shavitt, R. G., do Rosário, M. C., de Mathis, M. A., Miguel, E. C., & Torres, A. R. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2012.12.006 · Cited by 136
Affective regulation in trichotillomania: Evidence from a large-scale internet survey
Shusterman, A., Feld, L., Baer, L., & Keuthen, N. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.004 · Cited by 127 · cited 1×
“found that these individuals have greater difficulty regulating negative affective states than do healthy comparison subjects (51).”
BackgroundTrichotillomania: neurobiology and treatment
Chamberlain, S. R., Odlaug, B. L., Boulougouris, V., Fineberg, N. A., & Grant, J. E. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.02.002 · Cited by 126
Self-citationDbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial
Keuthen, N. J., Rothbaum, B. O., Fama, J., Altenburger, E., Falkenstein, M. J., Sprich, S. E., Kearns, M., Meunier, S., Jenike, M. A., & Welch, S. S. (2012) · Journal of Behavioral Addictions · doi:10.1556/jba.1.2012.003 · Cited by 124
Quality of life and clinical severity in pathological skin picking and trichotillomania
Odlaug, B. L., Kim, S. W., & Grant, J. E. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.06.004 · Cited by 118
Self-citationBehavioral activity associated with onset in chronic tic and habit disorder
O’Connor, K. P., Brisebois, H., Brault, M., Robillard, S., & Loiselle, J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00051-7 · Cited by 116
Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study
Chamberlain, S. R., Menzies, L. A., Fineberg, N. A., del Campo, N., Suckling, J., Craig, K. J., Müller, U., Robbins, T. W., Bullmore, E. T., & Sahakian, B. J. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.048314 · Cited by 109
Self-citationFerrão, Y. A., Miguel, E., & Stein, D. J. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.06.008 · Cited by 107
Pharmacotherapy for trichotillomania
Rothbart, R., Amos, T., Siegfried, N., Ipser, J. C., Fineberg, N., Chamberlain, S. R., & Stein, D. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007662.pub2 · Cited by 106
Self-citationImpulse-Control Disorders in a College Sample
Odlaug, B. L., & Grant, J. E. (2010) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.09m00842whi · Cited by 99
Self-citationThe phenomenology of hairpulling in a community sample.
Duke, D., Bodzin, D., Tavares, P., Geffken, G., & Storch, E. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.07.015 · Cited by 94
Clinical characteristics of trichotillomania with trichophagia
Grant, J. E., & Odlaug, B. L. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.05.002 · Cited by 91
Self-citationEvidence for Reduced Cerebellar Volumes in Trichotillomania
Keuthen, N. J., Makris, N., Schlerf, J. E., Martis, B., Savage, C. R., McMullin, K. G., Seidman, L. J., Schmahmann, J. D., Kennedy, D. N., Hodge, S. M., et al. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.06.013 · Cited by 88
An epidemiological study of trichotillomania in Israeli adolescents.
King, R. A., Zohar, A., Ratzoni, G., Binder, M., Kron, S., Dycian, A., Cohen, D., Pauls, D., & Apter, A. (1995) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/00004583-199509000-00019 · Cited by 85
Magnetic resonance brain imaging in women with obsessive-compulsive disorder and trichotillomania.
Stein, D. J., Coetzer, R., Lee, M.-Y., Davids, B., & Bouwer, C. (1997) · Psychiatry Research · doi:10.1016/s0925-4927(97)00010-3 · Cited by 82
Reduced Brain White Matter Integrity in Trichotillomania
Chamberlain, S. R., Hampshire, A., Menzies, L. A., Garyfallidis, E., Grant, J. E., Odlaug, B. L., Craig, K. J., Fineberg, N. A., & Sahakian, B. J. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.109 · Cited by 79
Self-citationOdlaug, B. L., Chamberlain, S. R., Derbyshire, K. L., Leppink, E. W., & Grant, J. E. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.08.010 · Cited by 69
Self-citationDepression, anxiety, and functional impairment in children with trichotillomania
Lewin, A. B., Piacentini, J., Flessner, C. A., Woods, D. W., Franklin, M. E., Keuthen, N. J., Moore, P., Khanna, M., March, J. S., Stein, D. J., et al. (2008) · Depression and Anxiety · doi:10.1002/da.20537 · Cited by 68
Retrospective Review of Treatment Outcome for 63 Patients With Trichotillomania
Keuthen, N. J., O'Sullivan, R. L., Goodchild, P., Rodriguez, D., Jenike, M. A., & Baer, L. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.4.560 · Cited by 65
Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study
Grant, J. E., Odlaug, B. L., Chamberlain, S. R., & Kim, S. W. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2347-8 · Cited by 63
Self-citationRoos, A., Grant, J. E., Fouché, J., Stein, D. J., & Löchner, C. (2014) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.11.029 · Cited by 61
Self-citationStepped care in the treatment of trichotillomania
Rogers, K., Banis, M., Falkenstein, M. J., Malloy, E. J., McDonough, L., Nelson, S. O., Rusch, N., & Haaga, D. A. F. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035744 · Cited by 59
Disordered reward processing and functional connectivity in trichotillomania: A pilot study
White, M. P., Shirer, W. R., Molfino, M. J., Tenison, C., Damoiseaux, J. S., & Greicius, M. D. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.05.014 · Cited by 53
Skin picking and trichotillomania in adults with obsessive-compulsive disorder
Lovato, L. M., Ferrão, Y. A., Stein, D. J., Shavitt, R. G., Fontenelle, L. F., Vivan, A. D. S., Miguel, E. C., & Cordioli, A. V. (2011) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.06.008 · Cited by 53
MRI‐based morphometric topographic parcellation of human neocortex in trichotillomania
Grachev, I. D. (1997) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.1997.tb03205.x · Cited by 50
A family study of trichotillomania and chronic hair pulling
Keuthen, N. J., Altenburger, E. M., & Pauls, D. (2014) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32218 · Cited by 48
Hair pulling and its affective correlates in an African-American university sample
Mansueto, C. S., Thomas, A. M., & Brice, A. L. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.08.004 · Cited by 41
Siddiqui, E., Naeem, S. S., Naqvi, H. A., & Ahmed, B. (2012) · BMC Research Notes · doi:10.1186/1756-0500-5-614 · Cited by 39
Brain activation during implicit sequence learning in individuals with trichotillomania.
Rauch, S., Wright, C. I., Savage, C., Martis, B., McMullin, K., Wedig, M., Gold, A. L., & Keuthen, N. (2007) · Psychiatry Research · doi:10.1016/j.pscychresns.2006.09.002 · Cited by 38
Lee, J. A., Kim, C. K., Jahng, G., Hwang, L., Cho, Y., Kim, Y. J., Lee, W., Moon, S., Cho, A., & Bahn, G. H. (2010) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2010.06.031 · Cited by 29
White matter integrity in hair-pulling disorder (trichotillomania)
Roos, A., Fouché, J., Stein, D. J., & Löchner, C. (2012) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2012.08.005 · Cited by 26
Frequency and Treatment of Trichotillomania in Poland
Szepietowski, J. C., Salomon, J., Pacan, P., Hrehorów, E., & Zalewska, A. (2009) · Acta Dermato Venereologica · doi:10.2340/00015555-0630 · Cited by 19
Psychological treatments for trichotillomania: Update and future directions
Rehm, I., Moulding, R., & Nedeljkovic, M. (2015) · Australasian Psychiatry · doi:10.1177/1039856215590029 · Cited by 16
Longitudinal Course of Body-Focused Repetitive Behaviors in Obsessive-Compulsive Disorder
Grant, J., Mancebo, M., Mooney, M. E., Eisen, J., & Rasmussen, S. (2015) · Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists · doi:10.1177/104012371502700304 · Cited by 15
Self-citation
Flagged first, then by citations
Research works printed but not linked: 8
- Christenson GA, 1991, J Clin Psychiatry, 52, 415
- Lewin AB, 2009, Depress Anxiety, 26, 521
- Christenson GA, 1995, Psychiatr Times, 12, 44
- Cohen LJ, 1995, J Clin Psychiatry, 56, 319
- Christenson GA, 1999, Trichotillomania, 1
- Grant JE, 2015, Ann Clin Psychiatry, 27, 185
- Fineberg NA, 2008, Isr J Psychiatry Relat Sci, 45, 151
- Rothbart R, 2013, Cochrane Database Syst Rev, 11, CD007662
Cited by
Sorted by citations
Prevalence, gender correlates, and co-morbidity of trichotillomania
Grant, J. E., Dougherty, D. D., & Chamberlain, S. R. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112948 · Cited by 190
Self-citationCommon causes of hair loss – clinical manifestations, trichoscopy and therapy
Alessandrini, A. M., Bruni, F., Piraccini, B. M., & Starace, M. V. R. (2020) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.17079 · Cited by 174
Farhat, L. C., Olfson, E., Nasir, M., Levine, J. L. S., Li, F., Miguel, E. C., & Bloch, M. H. (2020) · Depression and Anxiety · doi:10.1002/da.23028 · Cited by 133
Pampaloni, I., Marriott, S., Pessina, E., Fisher, C., Govender, A., Mohamed, H., Chandler, A., Tyagi, H., Morris, L., & Pallanti, S. (2022) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2022.152342 · Cited by 95
Prevalence and gender distribution of trichotillomania: A systematic review and meta-analysis.
Thomson, H., Farhat, L., Olfson, E., Levine, J. L. S., & Bloch, M. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.06.058 · Cited by 65
Metadata
- Authors
- Grant, J. E., & Chamberlain, S. R.
- Affiliations
- University of Cambridge (GB)
- Venue
- American Journal of Psychiatry
- Published
- 2016-09-01
- Volume
- 173
- Issue
- 9
- Pages
- 868-874
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC5328413
- OpenAlex
- W4239452805
- Cited by
- 252
- References
- 57
- Citations by year
- 2026: 23 · 2025: 37 · 2024: 25 · 2023: 26 · 2022: 31 · 2021: 49 · 2020: 26 · 2019: 15 · 2018: 11 · 2017: 8 · 2016: 1
- FWCI
- 15.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Wellcome Trust (110,049/Z/15/Z, 110049)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- trichotillomania, hair pulling, hair loss, obsessive-compulsive disorder, prevalence, habit reversal therapy, N-acetylcysteine, olanzapine, treatment options, DSM-5 classification
- MeSH terms
- Female, Humans, Psychotherapy, Trichotillomania, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review