Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;53(1):165-171.
doi: 10.1007/s10578-020-01117-y. Epub 2021 Jan 8.

Sex Differences in Age at Onset and Presentation of Trichotillomania and Trichobezoar: A 120-Year Systematic Review of Cases

Ivar Snorrason  1   2   3 , Emily J Ricketts  4 , Aliza T Stein  5 , Hardian Thamrin  6 , SoJeong J Lee  4 , Hannah Goldberg  4 , Yuan Hu  7 , Thröstur Björgvinsson  7
Affiliations

Sex Differences in Age at Onset and Presentation of Trichotillomania and Trichobezoar: A 120-Year Systematic Review of Cases

Ivar Snorrason et al. Child Psychiatry Hum Dev. 2022 Feb.

Abstract

Trichotillomania (hair-pulling disorder) has high female preponderance. It has been suggested that onset in early childhood represents a distinct developmental subtype that is characterized by higher prevalence of males compared to later onset cases. However, the empirical literature is scarce. We conducted a systematic review of case reports to examine the distribution of age at onset/presentation in males and females with trichotillomania or trichobezoar (a mass of hair in the gastrointestinal tract resulting from ingesting hair). We identified 1065 individuals with trichotillomania and 1248 with trichobezoar. In both samples, males, compared to females, had earlier age at presentation and greater proportion of cases in early childhood. These sex differences remained after potential confounding variables were accounted for. The results showed similar sex differences for age at onset, which was reported in 734 and 337 of the trichotillomania and trichobezoar cases, respectively. The findings may reflect neurodevelopmental underpinnings in early childhood trichotillomania.

Keywords: Gender; Hair pulling; Trichobezoar; Trichophagia; Trichotillomania.

PubMed Disclaimer

References

    1. McCarthy MM, Nugent BM, Lenz KM (2017) Neuroimmunology and neuroepigenetics in the establishment of sex differences in the brain. Nat Rev Neurosci 18:471–484 - DOI
    1. Rutter M, Caspi A, Moffitt TE (2003) Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies. J Child Psychol Psychiatry 44:1092–1115 - DOI
    1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing, Philadelphia - DOI
    1. Snorrason I, Belleau EL, Woods DW (2012) How related are hair pulling disorder (trichotillomania) and skin picking disorder? A review of evidence for comorbidity, similarities and shared etiology. Clin Psychol Rev 32:618–629 - DOI
    1. Ricketts EJ, Snorrason I, Kircanski K, Alexander JR, Stiede JT, Thamrin H et al (2019) A latent profile analysis of age of onset in trichotillomania. Ann Clin Psychiatry 31:169–178 - PubMed

Publication types

LinkOut - more resources