Meta-Analysis of Trichotillomania (TTM) Data Refutes Female Predominance

Males and Females May have Similar Rates of Trichotillomania and Hair Pulling

Authors from the US and Brazil set out to perform a systematic review and meta-analysis to provide estimates on the prevalence of TTM and hair-pulling.

Of the 713 records identified through various database searches, the authors examined 30 studies involving 38,526 participants. Meta-analyses indicated TTM had a prevalence of 1.14% (95% CI 0.66%, 1.96%), while any hair-pulling behavior had a prevalence of 8.84% (95% CI 6.33%, 12.20%).

Meta-analyses showed that male and females were at similar risk of any hair-pulling when there was no requirement for noticeable hair loss in the definition  (OR = 0.90, 95% CI 0.72, 1.64, p = 0.33).  In contrast, females were at an increased risk of  hair-pulling when noticeable hair loss was required (OR = 2.23, 95% CI 1.60, 3.10, p < 0.0001.

The meta-analyses did not indicate female preponderance in TTM  (OR = 1.29; 95% CI 0.91, 1.83; I2 = 28%, p = 0.15).

 Discussion and Conclusion

The authors concluded that  TTM impacts ~1% of the population, and general hair-pulling behaviours affects ~8%. This study draws attention to the significant public health impact of this understudied condition and helps clarify some long held myths that females are vastly more likely to be diagnosed with trichotillomania than males.   

REFERENCE

Thomson H et al. Prevalence and gender distribution of trichotillomania: A systematic review and meta-analysis. J Psychiatr Res. 2022 Jul 1;153:73-81.