Trichotillomania (Hair Pulling)

To the Editor: With reference to the recent report by Swedo et al. (Aug. 24 issue) 1 on trichotillomania and the accompanying editorial by Jenike, 2 we may have discovered another aspect of the "hidden epidemic" of obsessive—compulsive and related disorders. We recently questioned five patients with bulimia nervosa as defined in the Diagnostic and Statistical Manual of Mental Disorders , 3 and found to our surprise that three of them had trichotillomania. They were more reluctant to talk about their trichotillomania than about their bulimia. In all patients the trichotillomania was severe enough to cause appreciable bald spots, although the patients had . . .