TY - JOUR
T1 - Trichotillomania comorbidity in a sample enriched for familial obsessive-compulsive disorder
AU - Gerstenblith, Ted Avi
AU - Jaramillo-Huff, Ashley
AU - Ruutiainen, Tuua
AU - Nestadt, Paul S.
AU - Samuels, Jack F.
AU - Grados, Marco A.
AU - Cullen, Bernadette A.
AU - Riddle, Mark A.
AU - Liang, Kung-Yee
AU - Greenberg, Benjamin D.
AU - Rasmussen, Steven A.
AU - Rauch, Scott L.
AU - McCracken, James T.
AU - Piacentini, John
AU - Knowles, James A.
AU - Nestadt, Gerald
AU - Bienvenu, O. Joseph
N1 - Funding Information:
National Institutes of Health (NIH) grants MH50125 , RR00052 , NS42609 , MH64543 , MH80221 and MH66284 supported this work. The NIH had no role in study design; collection, analysis, or interpretation of data; writing the report, or the decision to submit the manuscript for publication. We thank the many families who participated in our studies, the Obsessive-Compulsive Foundation, and coordinators and clinicians at each OCGS site. Finally, we thank Drs. Abby Fyer (Columbia University College of Physicians and Surgeons), Dennis Murphy (deceased, National Institute of Mental Health, Laboratory of Clinical Science), and David Pauls (retired, Harvard Medical School) for their important roles in the OCGS.
Funding Information:
National Institutes of Health (NIH) grants MH50125, RR00052, NS42609, MH64543, MH80221 and MH66284 supported this work. The NIH had no role in study design; collection, analysis, or interpretation of data; writing the report, or the decision to submit the manuscript for publication. We thank the many families who participated in our studies, the Obsessive-Compulsive Foundation, and coordinators and clinicians at each OCGS site. Finally, we thank Drs. Abby Fyer (Columbia University College of Physicians and Surgeons), Dennis Murphy (deceased, National Institute of Mental Health, Laboratory of Clinical Science), and David Pauls (retired, Harvard Medical School) for their important roles in the OCGS.
Publisher Copyright:
© 2019
PY - 2019/10
Y1 - 2019/10
N2 - Background: This study addresses the strength of associations between trichotillomania (TTM) and other DSM-IV Axis I conditions in a large sample (n = 2606) enriched for familial obsessive-compulsive disorder (OCD), to inform TTM classification. Methods: We identified participants with TTM in the Johns Hopkins OCD Family Study (153 families) and the OCD Collaborative Genetics Study, a six-site genetic linkage study of OCD (487 families). We used logistic regression (with generalized estimating equations) to assess the strength of associations between TTM and other DSM-IV disorders. Results: TTM had excess comorbidity with a number of conditions from different DSM-IV chapters, including tic disorders, alcohol dependence, mood disorders, anxiety disorders, impulse-control disorders, and bulimia nervosa. However, association strengths (odds ratios) were highest for kleptomania (6.6), pyromania (5.8), OCD (5.6), skin picking disorder (4.4), bulimia nervosa (3.5), and pathological nail biting (3.4). Conclusions: TTM is comorbid with a number of psychiatric conditions besides OCD, and it is strongly associated with other conditions involving impaired impulse control. Though DSM-5 includes TTM as an OCD-related disorder, its comorbidity pattern also emphasizes the impulsive, appetitive aspects of this condition that may be relevant to classification.
AB - Background: This study addresses the strength of associations between trichotillomania (TTM) and other DSM-IV Axis I conditions in a large sample (n = 2606) enriched for familial obsessive-compulsive disorder (OCD), to inform TTM classification. Methods: We identified participants with TTM in the Johns Hopkins OCD Family Study (153 families) and the OCD Collaborative Genetics Study, a six-site genetic linkage study of OCD (487 families). We used logistic regression (with generalized estimating equations) to assess the strength of associations between TTM and other DSM-IV disorders. Results: TTM had excess comorbidity with a number of conditions from different DSM-IV chapters, including tic disorders, alcohol dependence, mood disorders, anxiety disorders, impulse-control disorders, and bulimia nervosa. However, association strengths (odds ratios) were highest for kleptomania (6.6), pyromania (5.8), OCD (5.6), skin picking disorder (4.4), bulimia nervosa (3.5), and pathological nail biting (3.4). Conclusions: TTM is comorbid with a number of psychiatric conditions besides OCD, and it is strongly associated with other conditions involving impaired impulse control. Though DSM-5 includes TTM as an OCD-related disorder, its comorbidity pattern also emphasizes the impulsive, appetitive aspects of this condition that may be relevant to classification.
KW - Comorbidity
KW - Impulse-control disorder
KW - Obsessive-compulsive disorder
KW - Trichotillomania
KW - classification
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U2 - 10.1016/j.comppsych.2019.152123
DO - 10.1016/j.comppsych.2019.152123
M3 - Article
C2 - 31518848
AN - SCOPUS:85071907593
VL - 94
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
SN - 0010-440X
M1 - 152123
ER -