Trichotillomania and dermatillomania: Clinical and psychopathological relationships

Objective. To conduct a comparative analysis of trichotillomania (TM) and dermatillomania (DM), examining their associations with symptoms of obsessive-compulsive disorder (OCD), characteristics of impulsivity, and the severity of anxiety and depression. Material and methods. An online survey was administered to 140 individuals, aged 13 to 54, comprising 134 females and 6 males. The following standardized questionnaires were utilized: Massachusetts General Hospital Hair Pulling Scale, Milwaukee Inventory for Subtypes of Trichotillomania, Skin Self Picking Scale, OCD Questionnaire, Barratt Impulsiveness Scale, and the Hospital Anxiety and Depression Scale (HADS). Results. A moderate negative Spearman correlation was identified between the severity of TM and DM (ρ=–0.355), suggesting an inverse relationship between these two pathological behaviors. The most significant relationships were observed between DM and the focused TM. Among the components of OCD, hair-pulling was correlated with obsessive thoughts, while DM exhibited associations with the overall OCD score, obsessive thoughts, checking rituals, and mysophobia. Notably, only DM demonstrated significant correlations with the Barratt Impulsiveness Questionnaire score — in particular, the inattention scale (ρ=0.226). TM showed only one significant correlation with anxiety as measured by HADS (ρ=0.245), whereas DM presented multiple significant associations with both anxiety and depression. Conclusions. The findings indicate that DM is associated with a broader range of OCD manifestations, characteristics of impulsiveness according to the Barratt Impulsiveness Questionnaire, and severity of anxiety and depression when compared to TM. Therefore, skin excoriation as a manifestation of a mental disorder warrants equal consideration and attention to that of hair-pulling behavior.