A Case-Control Study of Trichotillomania Patients Using a National Database

Trichotillomania (TTM) is a body-focused repetitive disorder linked to psychiatric comorbidities. Comprehensive studies mapping its associations with a range of conditions remain limited. This study examines TTMs associations with psychiatric, neurodevelopmental, substance-related, reproductive, and social factors using a national database.

We performed a case-control study using the All of Us Research Program database. TTM cases (n = 40) were matched to controls (n = 400) based on age, sex, and ethnicity. Multivariate logistic regression was used to examine associations with comorbidities and lifestyle factors, controlling for demographic variables.

TTM was significantly associated with obsessive-compulsive disorder (odds ratio [OR] 18.3), borderline personality disorder (OR 15), anxiety disorders (OR 10.2), alcohol abuse (OR 6.13), depression (OR 5.89), and vitamin D deficiency (OR 4.2) (all p < 0.01). Other significant associations included fatigue, social anxiety, post-traumatic stress disorder, ADHD, and difficulty running errands alone.

Our findings highlight the strong association between TTM and a wide range of psychiatric and behavioral conditions, emphasizing the need for integrated treatment strategies addressing both psychiatric and physical aspects.