Clinical Characteristics and Comorbidities of Patients with Trichotillomania and Skin Picking Disorder Who Admitted to a Psychodermatology Outpatient Clinic: A Comparative Study

Abstract

Objective: Trichotillomania (TTM) and Skin Picking Disorder (SPD) are psychiatric disorders characterized by chronic and compulsive pulling and picking to remove hair and skin. There are very few studies on the clinical and phenomenological differences of TTM and SPD. In this study we aimed to compare the clinical characteristics and comorbidities of patients diagnosed with TTM and SPD. Method: We enrolled 56 TTM and 113 SPD patients who were assessed with SCID-I for DSM-IV. In addition, we evaluated the DSM-5 criteria for Obsessive and Compulsive Disorder spectrum. We also utilized sociodemographic form, the Clinical Global Impression Scale, the Beck Anxiety Inventory and the Beck Depression Inventory. Results: Although patients with TTM and SPD had many common clinical features and comorbidities, statistically significant differences were determined in the number of the pulling/picking sites (Z=-7.084; p<0.001), the type of the outpatient clinics which they initially consulted (X2=19.451; p<0.001), reasons for pulling/picking behavior (p<0.05) and comorbidities of depression (x2=3.878; p=0.049) and onychophagia (X2=7.173; p=0.007). Disease severity and depression and anxiety scores of patients with TTM and SPD who had comorbid diseases were statistically significantly higher compared to the patients without comorbidities (p<0.005). Conclusion: TTM and SPD often present with common clinical characteristics and a high incidence of psychiatric comorbidities. Finding out the clinical characteristics, the triggering factors and determining the comorbidities are important to gain an understanding of the course and determine the appropriate treatment for these disorders. Hence, phenomenological studies on large patient populations are needed.