Journal of Genetics

, Volume 91, Issue 2, pp 259–262 | Cite as

The genetic factors influencing the development of trichotillomania

Review Article


Trichotillomania (TTM), an obsessive–compulsive spectrum disorder (OCSD), is a psychiatric condition characterized by repetitive hair pulling. Evidence from family and twin studies suggest a heritable link of TTM. Functional polymorphisms in genes involved in neuronal pathways might influence the susceptibility to TTM. This review is an attempt to compile the genetic factors reported to modify the development of TTM.


trichotillomania familial genes polymorphism 


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  1. American Psychiatric Association 1994 Diagnostic and statistical manual of mental disorders, 4th edition. American Psychiatric Association, Washington D.C., USA.Google Scholar
  2. American Psychiatric Association 2000 DSM-IV-TR. American Psychiatric Association, Washington D.C., USA.Google Scholar
  3. Bienvenu O. J., Wang Y., Shugart Y. Y., Welch J. M., Grados M. A., Fyer A. J. et al. 2009 Sapap3 and pathological grooming in humans: results from the OCD collaborative genetics study. Am. J. Med. Genet. B Neuropsychiatr. Genet. 150, 710–720.Google Scholar
  4. Christenson G. A., Pyle R. L. and Mitchell J. E. 1991 Estimated lifetime prevalence of trichotillomania in college students. J. Clin. Psychiatry 52, 415–417.PubMedGoogle Scholar
  5. Christenson G. A., Mackenzie T. B. and Reeve E. A. 1992 Familial trichotillomania. Am. J. Psychiatry 149, 283.PubMedGoogle Scholar
  6. Dodman N. H., Karlsson E. K., Moon-Fanelli A., Galdzicka M., Perloski M., Shuster L. et al. 2010 A canine chromosome 7 locus confers compulsive disorder susceptibility. Mol. Psychiatry 15, 8–10.PubMedCrossRefGoogle Scholar
  7. Eliott A. J. and Fuqua R. W. 2000 Trichotilomania: conceptualization, measurement, and treatment. Behav. Ther. 31, 529–545.CrossRefGoogle Scholar
  8. Galski T. 1983 Hair pulling (trichotillomania). Psychoanal. Rev. 70, 331–346.PubMedGoogle Scholar
  9. Hemmings S. M., Kinnear C. J., Lochner C., Seedat S., Corfield V. A., Moolman-Smook J. C. and Stein D. J. 2006 Genetic correlates in trichotillomania–a case–control association study in the South African Caucasian population. Isr. J. Psychiatry Relat. Sci. 43, 93–101.PubMedGoogle Scholar
  10. Himle J. A., Bordnick P. S. and Thyer B. A. 1995 A comparison of trichotillomania and obsessive-compulsive disorder. J. Psychopathol. Behav. Assess. 17, 251–260.CrossRefGoogle Scholar
  11. Hollander E. B. and Benzaquen S. D. 1997 The obsessive-compulsive spectrum disorders. Int. Rev. Psychiatry 9, 99–109.CrossRefGoogle Scholar
  12. Katayama K., Yamada K., Ornthanalai V. G., Inoue T., Ota M., Murphy N. P. and Aruga J. 2010 Slitrk1-deficient mice display elevated anxiety-like behavior and noradrenergic abnormalities. Mol. Psychiatry 15, 177–184.PubMedCrossRefGoogle Scholar
  13. Kerbeshian J. and Burd L. 1991 Familial trichotillomania. Am. J. Psychiatry 148, 684–685.PubMedGoogle Scholar
  14. Khait V. D., Huang Y. Y., Zalsman G., Oquendo M. A., Brent D. A., Harkavy-Friedman J. M. and Mann J. J. 2005 Association of serotonin 5-HT2A receptor binding and the T102C polymorphism in depressed and healthy Caucasian subjects. Neuropsychopharmacology 30, 166–172.PubMedCrossRefGoogle Scholar
  15. King R. A., Scahill L., Vitulano L. A., Schwab-Stone M., Tercyak Jr K. P. and Riddle M. A. 1995 Childhood trichotillomania: clinical phenomenology, comorbidity, and family genetics. J. Am. Acad. Child Adolesc. Psychiatry 34, 1451–1459.PubMedCrossRefGoogle Scholar
  16. Lenane M. C., Swedo S. E., Rapoport J. L., Leonard H., Sceery W. and Guroff J. J. 1992 Rates of obsessive compulsive disorder in first degree relatives of patients with trichotillomania: a research note. J. Child Psychol. Psychiatry 33, 925–933.PubMedCrossRefGoogle Scholar
  17. Lochner C., Hemmings S. M., Kinnear C. J., Niehaus D. J., Nel D. G., Corfield V. A. et al. 2005 Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates. Compr. Psychiatry 46, 14–19.PubMedCrossRefGoogle Scholar
  18. Mah A. K. 2010 SLITRK5, a protein that links striatal deficits to OCD-like behaviours in mice. Clin. Genet. 78, 350–352.PubMedCrossRefGoogle Scholar
  19. Mansueto C. S., Thomas A. M. and Brice A. L. 2007 Hair pulling and its affective correlates in an African-American university sample. J. Anxiety Disord. 21, 590–599.PubMedCrossRefGoogle Scholar
  20. Miguel E. C., Baer L., Coffey B. J., Rauch S. L., Savage C. R., O’Sullivan R. L. et al. 1997 Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette’s syndrome. Br. J. Psychiatry 170, 140–145.PubMedCrossRefGoogle Scholar
  21. Molloy A. G. and Waddington J. L. 1987 Assessment of grooming and other behavioural responses to the D-1 dopamine receptor agonist SK & F 38393 and its R- and S-enantiomers in the intact adult rat. Psychopharmacology 92, 164–168.PubMedCrossRefGoogle Scholar
  22. Nicolini H., Arnold P., Nestadt G., Lanzagorta N. and Kennedy J. L. 2009 Overview of genetics and obsessive-compulsive disorder. Psychiatry Res. 170, 7–14.PubMedCrossRefGoogle Scholar
  23. Norrholm S. D. and Ressler K. J. 2009 Genetics of anxiety and trauma-related disorders. Neuroscience 164, 272–287.PubMedCrossRefGoogle Scholar
  24. Novak C. E., Keuthen N. J., Stewart S. E. and Pauls D. L. 2009 A twin concordance study of trichotillomania. Am. J. Med. Genet. B Neuropsychiatr. Genet. 150, 944–949.Google Scholar
  25. Okuyama Y., Ishiguro H., Toru M. and Arinami T. 1999 A genetic polymorphism in the promoter region of DRD4 associated with expression and schizophrenia. Biochem. Biophys. Res. Commun. 258, 292–295.PubMedCrossRefGoogle Scholar
  26. Ooki S. 2005 Genetic and environmental influences on finger-sucking and nail-biting in Japanese twin children. Twin Res. Hum. Genet. 8, 320–327.PubMedCrossRefGoogle Scholar
  27. O’Rourke J. A., Scharf J. M., Yu D. and Pauls D. L. 2009 The genetics of Tourette syndrome: a review. J. Psychosom. Res. 67, 533–545.PubMedCrossRefGoogle Scholar
  28. Polesskaya O. O. and Sokolov B. P. 2002 Differential expression of the “C” and “T” alleles of the 5-HT2A receptor gene in the temporal cortex of normal individuals and schizophrenics. J. Neurosci. Res. 67, 812–822.PubMedCrossRefGoogle Scholar
  29. Rothbaum B. O., Shaw L., Morris R. and Ninan P. T. 1993 Prevalence of trichotillomania in a college freshman population. J. Clin. Psychiatry 54, 72–73.PubMedGoogle Scholar
  30. Rubinstein M., Phillips T. J., Bunzow J. R., Falzone T. L., Dziewczapolski G., Zhang G. et al. 1997 Mice lacking dopamine D4 receptors are supersensitive to ethanol, cocaine, and methamphetamine. Cell 90, 991–1001.PubMedCrossRefGoogle Scholar
  31. Sanderson K. V. and Hall-Smith P. 1970 Tonsure trichotillomania. Br. J. Dermatol. 82, 343–350.PubMedCrossRefGoogle Scholar
  32. Scannevin R. H. and Huganir R. L. 2000 Postsynaptic organization and regulation of excitatory synapses. Nat. Rev. Neurosci. 1, 133–141.PubMedCrossRefGoogle Scholar
  33. Schlosser S., Black D. W., Blum N. and Goldstein R. B. 1994 The demography, phenomenology, and family history of 22 persons with compulsive hair pulling. Ann. Clin. Psychiatry 6, 147–152.PubMedCrossRefGoogle Scholar
  34. Stein D. J. 2000 Neurobiology of the obsessive-compulsive spectrum disorders. Biol. Psychiatry 47, 296–304.PubMedCrossRefGoogle Scholar
  35. Swedo S. E. and Rapoport J. S. 1991 Rates of obsessive compulsive disorder in first degree relatives of patients with trichotillomania: a research note. annotation: Trichotillomania. J. Child Psychol. Psychiatry 32, 401–409.PubMedCrossRefGoogle Scholar
  36. Swedo S. E. and Leonard H. L. 1992 Trichotillomania. An obsessive compulsive spectrum disorder? Psychiatr. Clin. North Am. 15, 777–790.PubMedGoogle Scholar
  37. Swedo S. E., Leonard H. L., Rapoport J. L., Lenane M. C., Goldberger E. L. and Cheslow D. L. 1989 A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N. Engl. J. Med. 321, 497–501.PubMedCrossRefGoogle Scholar
  38. Tarazi F. I. and Baldessarini R. J. 1999 Dopamine D4 receptors: significance for molecular psychiatry at the millennium. Mol. Psychiatry 4, 529–538.PubMedCrossRefGoogle Scholar
  39. Van Ameringen M., Mancini C., Oakman J. M. and Farvolden P. 1999 The potential role of haloperidol in the treatment of trichotillomania. J. Affect Disord. 56, 219–226.PubMedCrossRefGoogle Scholar
  40. Wachtel S. R., Brooderson R. J. and White F. J. 1992 Parametric and pharmacological analyses of the enhanced grooming response elicited by the D1 dopamine receptor agonist SKF 38393 in the rat. Psychopharmacology 109, 41–48.PubMedCrossRefGoogle Scholar
  41. Welch J. M., Lu J., Rodriguiz R. M., Trotta N. C., Peca J., Ding J. D. et al. 2007 Cortico-striatal synaptic defects and OCD-like behaviours in Sapap3-mutant mice. Nature 448, 894–900.PubMedCrossRefGoogle Scholar
  42. Zuchner S., Cuccaro M. L., Tran-Viet K. N., Cope H., Krishnan R. R., Pericak-Vance M. A. 2006 SLITRK1 mutations in trichotillomania. Mol. Psychiatry 11, 887–889.PubMedCrossRefGoogle Scholar
  43. Zuchner S., Wendland J. R., Ashley-Koch A. E., Collins A. L., Tran-Viet K. N., Quinn K. et al. 2009 Multiple rare SAPAP3 missense variants in trichotillomania and OCD. Mol. Psychiatry 14, 6–9.PubMedCrossRefGoogle Scholar

Copyright information

© Indian Academy of Sciences 2011

Authors and Affiliations

  1. 1.Faculty of Health Sciences, Department of PsychiatryUniversity of StellenboschTygerbergRepublic of South Africa

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