Hallopeau, a 19th century French dermatologist, coined the term "trichotillomania" to describe an irresistible impulse to pluck out the hair, a peculiar affliction which remains a curiosity. Although dermatologists continue to emphasize the psychogenic etiology of hair-pulling, the psychiatric literature on the subject is scant. The symptoms have occasionally been diagnosed in childhood (when it occurs after the birth of a sibling), in acutely and chronically regressed psychotics, and in mentally defective or senile populations.
Recent research at the Bellevue Psychiatric Hospital, presented in the May issue of the Archives of General Psychiatry,1 indicates that trichotillomania may not be such an oddity after all. The investigators observed 19 patients, most of whom were young women, and concluded that they could delineate a syndrome of chronic trichotillomania with onset in adolescence, accompanied variably by depression, school problems, overconcern with weight, and wig-wearing. A particularly surprising feature was the presence of