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Aim: Trichotillomania (TTM) (hair-pulling disorder) is a relatively rare psychiatric condition. We are aware of no studies of this disorder in Arab Middle Eastern populations. We examine the prevalence and correlates of TTM in a community sample of individuals living in a large port city in western Saudi Arabia. Methods: An observational cross-sectional study of 511 adults aged 18 years or over living in Jeddah, Saudi Arabia, was conducted. After inquiring about demographic information and self-reported psychiatric disorders, the Massachusetts General Hospital Hair-Pulling Scale (MGH-HPS) was administered to assess symptoms of TMM. Results: A total of 9 of 511 participants (1.8%) scored above the cutoff for suspected TTM on the MGH-HPS, whereas 203 (39.7%) had a history of hair-pulling. Those with suspected TTM were more likely to be female (2.8% vs 0.4% in males, P = 0.047) and somewhat more likely to have a history of obsessive-compulsive disorder (OCD) (6.7% vs 1.5%, P = 0.093). Hair pulling was also more common in unmarried, not living with family, and unemployed. Among those with a history of hair-pulling, the most frequent locations were from the face (62.7%), head (55.7%), and legs (15.3%). Conclusions: While a history of hair-pulling is common in this community sample (40%), suspected TTM is much less prevalent (<2%), although not rare by any means. When present, the condition is more common in women and possibly in those with OCD.
RESUMO
BACKGROUND: Previous studies have investigated the pattern of dermatological diseases in some regions of Saudi Arabia, but studies on the prevalence of skin diseases in Jeddah are lacking. OBJECTIVES: Assess the pattern of skin diseases in Jeddah based on age and sex differences and compare the results with those of previous studies conducted in other regions of Saudi Arabia and the Middle East. DESIGN: A cross-sectional prevalence study, retrospective. SETTING: Dermatology clinic of King Abdulaziz University hospital. PATIENTS AND METHODS: Data obtained from electronic medical records were summarized and analyzed. We only included new patients, who first visited the clinic in 2017. MAIN OUTCOME MEASURES: Descriptive epidemiological data and statistical comparisons. SAMPLE SIZE: 1244. RESULTS: Among 3458 patients who attended the dermatology clinic, 1244 were new patients. There were 365 (29.3%) men and 879 (70.7%) women for a male-to-female ratio of 1:2.4. The mean (SD) age of the total population was 35 (3.8) years. The most common dermatological disease was dermatitis (n=266, 21.4%), followed by acne (n=195, 15.7%) and fungal infection (n=136, 10.9%). Atopic dermatitis was the most prevalent dermatome in children (41.7%), while acne was the most prevalent disease in adults (19.5%). The chi-square test indicated a significant difference between acne and sex (P=.007), with adult women being more commonly affected (79%) and for alopecia and sex (P less than .001), with women being more commonly affected (91.2%). CONCLUSIONS: There are slight differences in the prevalence of dermatological diseases in Jeddah, as shown in this study and other studies from other regions in Saudi Arabia and the Middle East. We recommend initiating awareness campaigns to increase knowledge about skin diseases, particularly in men, and improving dermatology-related training programs for primary health care physicians. A population-based study is warranted to clarify the prevalence of skin diseases in Saudi Arabia. LIMITATIONS: The inclusion of patients who visited the dermatology clinic only in 2017 and data collection from only registration records. CONFLICT OF INTEREST: None.
