1. Prevalence and predictors of hair pulling disorder and excoriation disorder in Tourette syndrome
- Author
-
Greenberg, Erica, Tung, Esther S, Gauvin, Caitlin, Osiecki, Lisa, Yang, Kelly G, Curley, Erin, Essa, Angela, Illmann, Cornelia, Sandor, Paul, Dion, Yves, Lyon, Gholson J, King, Robert A, Darrow, Sabrina, Hirschtritt, Matthew E, Budman, Cathy L, Grados, Marco, Pauls, David L, Keuthen, Nancy J, Mathews, Carol A, Scharf, Jeremiah M, and The Tourette Association of America International Consortium for Genetics
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Psychology ,Brain Disorders ,Tourette Syndrome ,Neurodegenerative ,Serious Mental Illness ,Mental Health ,Clinical Research ,Anxiety Disorders ,Mental health ,Child ,Comorbidity ,Female ,Humans ,Male ,Obsessive-Compulsive Disorder ,Prevalence ,Self-Injurious Behavior ,Surveys and Questionnaires ,Trichotillomania ,Trichotillomania/hair pulling disorder ,Excoriation disorder/skin picking disorder ,Tourette syndrome ,Obsessive-compulsive disorder ,Body-focused repetitive behaviors ,Tourette Association of America International Consortium for Genetics ,Obsessive–compulsive disorder ,Developmental & Child Psychology ,Clinical sciences ,Applied and developmental psychology ,Clinical and health psychology - Abstract
Trichotillomania/hair pulling disorder (HPD) and excoriation/skin picking disorder (SPD) are childhood-onset, body-focused repetitive behaviors that are thought to share genetic susceptibility and underlying pathophysiology with obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). We sought to determine the prevalence of DSM-5 HPD and SPD in TS patients, and to identify clinical factors most associated with their co-morbidity with TS. Participants included 811 TS patients recruited from TS specialty clinics for a multi-center genetic study. Patients were assessed using standardized, validated semi-structured interviews. HPD and SPD diagnoses were determined using a validated self-report questionnaire. HPD/SPD prevalence rates were calculated, and clinical predictors were evaluated using regression modeling. 3.8 and 13.0% of TS patients met DSM-5 criteria for HPD and SPD, respectively. In univariable analyses, female sex, OCD, and both tic and obsessive-compulsive symptom severity were among those associated with HPD and/or SPD. In multivariable analyses, only lifetime worst-ever motor tic severity remained significantly associated with HPD. Female sex, co-occurring OCD, ADHD, and motor tic severity remained independently associated with SPD. This is the first study to examine HPD and SPD prevalence in a TS sample using semi-structured diagnostic instruments. 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. This study also helps set a foundation for subsequent research regarding HPD/SPD risk factors, pathophysiology, and treatment models.
- Published
- 2018