Evidence map›Paper›PMID 41142044›Full record

ArticleBiological psychiatry global open science2025

Trichotillomania and Risk of Alcohol- and Drug-Related Problems.

Luis C Farhat, Kayoko Isomura, Ralf Kuja-Halkola, Isabell Brikell, Zheng Chang, Brian M D'Onofrio, Henrik Larsson, Paul Lichtenstein, Lorena Fernández de la Cruz, Anna Sidorchuk and 1 more

Abstract read
In one paragraph

Article in Biological psychiatry global open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Rethinking Trichotillomania.Biological psychiatry global open science · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Luis C FarhatDepartment of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Kayoko IsomuraCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and Stockholm Health Care Services, Region Stockholm, Sweden.
Ralf Kuja-HalkolaDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Isabell BrikellDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Zheng ChangDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Brian M D'OnofrioDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Henrik LarssonDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Paul LichtensteinDepartment of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden.
Lorena Fernández de la CruzCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and Stockholm Health Care Services, Region Stockholm, Sweden.
Anna SidorchukCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and Stockholm Health Care Services, Region Stockholm, Sweden.
David Mataix-ColsCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and Stockholm Health Care Services, Region Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Trichotillomania is an understudied psychiatric disorder characterized by repeated hair-pulling resulting in hair loss. Little is known about the risk of problematic substance use in this patient group. In this nationwide matched cohort study, we investigated the association between trichotillomania and substance-related problems. Methods: We linked various nationwide administrative and clinical registers in Sweden. Among 12,015,664 individuals living in the country from January 1, 1997, to December 31, 2020, we identified 1136 individuals with an ICD-10 diagnosis of trichotillomania at age ≥10 years (86.4% female, median age at first diagnosis 23.8 years [interquartile range 13.3-34.9 years]) and matched them with 11,360 unaffected individuals. The outcome was broadly defined as substance-related problems (alcohol- and drug-related disorders, suspected criminal offenses, and deaths). Stratified Cox proportional hazards regression was used to determine hazard ratios (HRs) for the association between trichotillomania and any substance-related problems. Results: Over a mean follow-up period of 6 years, substance-related problems were recorded for 137 (12.1%) individuals with trichotillomania and 399 (3.5%) matched individuals (crude incidence rates per 1000 person-years of 21.6 and 5.6, respectively). After controlling for sociodemographic covariates and parental substance-related problems, trichotillomania was associated with an increased relative risk of substance-related problems (HR, 3.12; 95% CI, 2.53-3.85). Adjusting also for comorbid psychiatric history did not meaningfully change the findings. Conclusions: Individuals with trichotillomania had a 3-fold increased risk of substance-related problems compared with unaffected individuals. Future research should examine the mechanisms underlying this association and inform the clinical management of the dual diagnoses.

Indexed as

Cohort studiesDisruptive, impulse control, and conduct disordersHair-pulling disorderObsessive-compulsive disorderRegistriesSubstance-related disorders

Identifiers

PMID41142044
PMCPMC12547216

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.