Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM‐V

  title={Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM‐V},
  author={Dan J Stein and Jon E. Grant and Martin E. Franklin and Nancy J. Keuthen and C. Lochner and Harvey S. Singer and Douglas W. Woods},
  journal={Depression and Anxiety},
In DSM‐IV‐TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD‐10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and… 


This review article provides the comprehensive information on the trichotillomania in terms of epidemiology Introduction, etiology, diagnostic criteria, prognosis, and various pharmacological treatments.

Trichotillomania: a psychopathological perspective and the psychiatric comorbidity of hair pulling.

It is speculated that hair pulling may function to provide short-term relief from stress and other unwanted emotional states, thus serving as a method of emotion regulation.

Stereotyped movement disorder in ICD-11.

There are a number of unresolved nosological questions regarding the relationships among stereotyped movement disorder, body-focused repetitive behavior disorders, and nonsuicidal self-injury as they relate to the ICD-11 classification of mental and behavioral disorders.

Prevalence and predictors of hair pulling disorder and excoriation disorder in Tourette syndrome

The prevalence of HPD and SPD in TS patients, and their association with increased tic severity and co-occurring OCD, suggests that clinicians should screen children with TS and related disorders for HPD/SPD, particularly in females and in those with co-Occurring OCD.

Classification of excoriation (skin picking) disorder: current status and future directions

A brief overview of evidence supporting the diagnostic validity and clinical utility of the SPD category is provided and future research directions are pointed out.

Trichotillomania as a Manifestation of Dementia

A patient who developed an early-onset cognitive decline with genetic, cerebrospinal fluid biomarker and structural and functional neuroimaging studies consistent with Alzheimer's disease and a review of the literature suggest that trichotillomania may be a compulsive-related symptom in dementias of different etiologies as they involve frontal areas and release primitive grooming behavior from frontostriatal dysfunction.


Changes in the diagnostic criteria and grouping of these disorders may have significant clinical implications, and will be reviewed in this article.



Trichotillomania, stereotypic movement disorder, and related disorders

Trichotillomania is currently classified as an impulse control disorder not otherwise classified, whereas body-focused behaviors other than hair-pulling may be diagnosed as stereotypic movement

Is trichotillomania a stereotypic movement disorder? An analysis of body-focused repetitive behaviors in people with hair-pulling.

The high rates of skin-picking and nail-biting in people with hair-pulling, and their association with increased disability, is consistent with previous clinical observations, and supports the argument that trichotillomania can usefully be conceptualized as a stereotypic disorder.

Trichotillomania and skin‐picking: A phenomenological comparison

Patients with trichotillomania and pathological skin‐picking were compared in terms of several demographic, clinical, clinical (comorbid axis I and II disorders), and personality variables.

Trichotillomania: behavioral symptom or clinical syndrome?

The pathology of trichotillomania spans both neurological and psychosocial domains, and a case is presented that illustrates many of the complexities of the phenomenology and treatment of this disorder.

Trichotillomania and obsessive-compulsive disorder. Discussion

Trichotillomania, a disorder characterized by repetitive hair pulling, has been only recently systematically investigated. Such research was encouraged by data that showed obsessive-compulsive

Trichotillomania. An obsessive compulsive spectrum disorder?

Trichotillomania and obsessive-compulsive disorder.

It is argued that a view of trichotillomania as an obsessive-compulsive spectrum disorder that may involve disturbances in grooming behaviors comprises a useful clinical and research heuristic.

Trichotillomania: Neurobiology and treatment

Skin picking as a symptom of body dysmorphic disorder.

It is suggested that compulsive skin picking is an under-recognized problem that commonly occurs as a symptom of BDD, is associated with significant morbidity, and may respond to psychiatric rather than dermatologic treatment.

Update on pathological skin picking

Animal neuroimaging research in related disorders such as obsessive-compulsive disorder and trichotillomania provides useful information for understanding PSP and may assist in the proper characterization of PSP.