Psychiatric Comorbidities in Pediatric Trichotillomania: A Multicenter Cohort Study.
behavioral health
hair‐pulling
pediatric
psychodermatology
trichotillomania
Journal
Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799
Informations de publication
Date de publication:
15 Oct 2024
15 Oct 2024
Historique:
revised:
18
09
2024
received:
15
03
2024
accepted:
01
10
2024
medline:
16
10
2024
pubmed:
16
10
2024
entrez:
15
10
2024
Statut:
aheadofprint
Résumé
Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients. This case-control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US-based data from the TriNetX global research network. TTM patients (ICD-10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD-10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive-compulsive disorder, anxiety disorders, dissociative, stress-related, and somatoform disorders, mood disorders, and suicide attempts compared to controls. TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841-2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2-3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826-2.765; p < 0.0001), obsessive-compulsive disorder (OR: 11.047; 8.822-13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387-3.7; p < 0.0001), dissociative, stress-related, and somatoform disorders (OR: 6.179; 3.935-9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288-2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121-2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event. Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients.
METHODS
METHODS
This case-control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US-based data from the TriNetX global research network. TTM patients (ICD-10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD-10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive-compulsive disorder, anxiety disorders, dissociative, stress-related, and somatoform disorders, mood disorders, and suicide attempts compared to controls.
RESULTS
RESULTS
TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841-2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2-3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826-2.765; p < 0.0001), obsessive-compulsive disorder (OR: 11.047; 8.822-13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387-3.7; p < 0.0001), dissociative, stress-related, and somatoform disorders (OR: 6.179; 3.935-9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288-2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121-2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event.
CONCLUSIONS
CONCLUSIONS
Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
American Psychiatric Association, and American Psychiatric Association Publishing. Diagnostic and Statistical Manual of Mental Disorders: DSM‐5, 5th ed (New Delhi: CBS Publishers & Distributors, Pvt. Ltd, 2017).
M. E. Franklin, K. Zagrabbe, and K. L. Benavides, “Trichotillomania and Its Treatment: A Review and Recommendations,” Expert Review of Neurotherapeutics 11, no. 8 (2011): 1165–1174, https://doi.org/10.1586/ern.11.93.
G. A. Christenson, R. L. Pyle, and J. E. Mitchell, “Estimated Lifetime Prevalence of Trichotillomania in College Students,” Journal of Clinical Psychiatry 52, no. 10 (1991): 415–417.
K. E. Panza, C. Pittenger, and M. H. Bloch, “Age and Gender Correlates of Pulling in Pediatric Trichotillomania,” Journal of the American Academy of Child and Adolescent Psychiatry 52, no. 3 (2013): 241–249, https://doi.org/10.1016/j.jaac.2012.12.019.
M. E. Franklin, C. A. Flessner, D. W. Woods, et al., “The Child and Adolescent Trichotillomania Impact Project: Descriptive Psychopathology, Comorbidity, Functional Impairment, and Treatment Utilization,” Journal of Developmental and Behavioral Pediatrics 29, no. 6 (2008): 493–500, https://doi.org/10.1097/DBP.0b013e31818d4328.
J. P. Harrison and M. E. Franklin, “Pediatric Trichotillomania,” Current Psychiatry Reports 14, no. 3 (2012): 188–196, https://doi.org/10.1007/s11920‐012‐0269‐8.
R. A. King, L. Scahill, L. A. Vitulano, M. Schwab‐Stone, K. P. Tercyak, Jr., and M. A. Riddle, “Childhood Trichotillomania: Clinical Phenomenology, Comorbidity, and Family Genetics,” Journal of the American Academy of Child and Adolescent Psychiatry 34, no. 11 (1995): 1451–1459, https://doi.org/10.1097/00004583‐199511000‐00011.
S. Comertoglu Arslan, A. Uzun Cicek, I. Ucuz, and H. Dogru, “Sociodemographic Variables, Clinical Characteristics, and Treatments in Children With Trichotillomania in Terms of Age and Gender: A Multicenter Study,” Nordic Journal of Psychiatry 77, no. 1 (2023): 36–45, https://doi.org/10.1080/08039488.2022.2052179.
R. M. Stemberger, A. M. Thomas, C. S. Mansueto, and J. G. Carter, “Personal Toll of Trichotillomania: Behavioral and Interpersonal Sequelae,” Journal of Anxiety Disorders 14, no. 1 (2000): 97–104, https://doi.org/10.1016/s0887‐6185(99)00028‐6.
D. F. Tolin, M. E. Franklin, G. J. Diefenbach, E. Anderson, and S. A. Meunier, “Pediatric Trichotillomania: Descriptive Psychopathology and an Open Trial of Cognitive Behavioral Therapy,” Cognitive Behaviour Therapy 36, no. 3 (2007): 129–144, https://doi.org/10.1080/16506070701223230.
G. L. Hanna, “Trichotillomania and Related Disorders in Children and Adolescents,” Child Psychiatry and Human Development 27, no. 4 (1997): 255–268, https://doi.org/10.1007/BF02353354.
A. Klobučar, V. Folnegović‐Šmalc, D. Kocijan‐Hercigonja, S. Sović, and L. Gulić, “Clinical Characteristics and Comorbidity of Pediatric Trichotillomania: The Study of 38 Cases in Croatia,” Psychiatria Danubina 30, no. 1 (2018): 79–84, https://doi.org/10.24869/psyd.2018.79.
N. S. Chandran, J. Novak, M. Iorizzo, R. Grimalt, and A. P. Oranje, “Trichotillomania in Children,” Skin Appendage Disorders 1, no. 1 (2015): 18–24, https://doi.org/10.1159/000371809.
C. Lochner, S. Demetriou, M. Kidd, B. Coetzee, and D. J. Stein, “Hair‐Pulling Does Not Necessarily Serve an Emotion Regulation Function in Adults With Trichotillomania,” Frontiers in Psychology 12 (2021): 675468, https://doi.org/10.3389/fpsyg.2021.675468.
O. Plana‐Ripoll, C. B. Pedersen, Y. Holtz, et al., “Exploring Comorbidity Within Mental Disorders Among a Danish National Population,” JAMA Psychiatry 76, no. 3 (2019): 259–270, https://doi.org/10.1001/jamapsychiatry.2018.3658.
S. Rangu and L. Castelo‐Soccio, “Trichotillomania in Children and the Different Approaches Between Dermatological and Behavioral Health Professionals at an Urban Tertiary Care Center,” Skin Appendage Disorders 7, no. 1 (2021): 1–7, https://doi.org/10.1159/000510524.
E. D. Henkel, S. D. Jaquez, and L. Z. Diaz, “Pediatric Trichotillomania: Review of Management,” Pediatric Dermatology 36, no. 6 (2019): 803–807, https://doi.org/10.1111/pde.13954.