How many people are affected by trich?

This is not such an easy answer to give.  It seems like no-one really agrees.  I asked around a bit, and these are the kind of answers I received.

L. Kaplan says the prevalance of TTM is 1-4%,
GA Christenson says it is 3% and DSM-1V says 1-2%
Kaplan and Christenson is very well known in academic circles for the TTM research that they're doing.

This agrees with the unofficial answer I got from TLC.   It seems like TLC doesn't have an official stand on this question.  But they also mentioned the same figures from various studies (betweem 1% and 4%), depending on the type of study that was done.

Converting the percentages to ratios, this is how it looks::
1% of the population means 1 out 100 people have TTM.
2% means 1 out of 50 people have TTM.
3% means 1 out 34 people have TTM.
4% means 1 out of 25 people have TTM.
That really brings home the fact that probably EVERYONE knows someone with TTM!!!

It was mentioned on the TTM mailer or BB once that there are more trichsters than diabetics, but according to searches done, the prevalance of diabetes is between 5% and 8%, so it doesn't seem that trich is as high as that.

This isn't much, but this is what I could find.

Update:  (someone sent me this info... very interesting!)

.... I found one study that quotes that repetetive hairpulling that does not lead to significant alopecia has prevalence rates from 10-15%!
(Either Rothbaum et al. or Stanley M.A., Borden, J.W., Bell, G.E. & Wagner,
A.L. (1994). Nonclinical Hairpulling: phenomenology and relation psychopathology. Journal of Anxiety Disorders. 8, 119-130.

Amanda

Update:    Tina Peta did a bit of calculations and this is what she came up with:

Trichotillomania Learning Center states 2-4% of the population may suffer from chronic hair pulling--that's 8
million people in the U.S. alone!

However when Dateline aired a segment on Trich in July 99, they stated 15 million people suffer in the US alone.

The new pamphlet TLC handed out at the recent conference states 1.5% males and 3.5% females in the USA suffer. Which would bring it to 5%  of the population suffers? Or 1 out of 20 people suffer.

As of today according to http://www.census.gov/cgi-bin/popclock   the USpopulation is 274,600,520 people. If 5% suffer from trich that brings us to 13.7 million in the US Alone.

Now take this one step farther. The world population today according to
http://www.census.gov/cgi-bin/ipc/popclockw is 6,063,644,450. If we use the same 5% figure for the US then 303 million suffer in the
entire world.

WOW if this is right. I am not a math scholar and just a mere Canadian Farm girl, so if my figures
are wrong please let me/us know.

Tina

Tina's Trichotillomania Site
http://www.trichotillomania.AB.CA/  ##  

And then our friend Geoff came up with this:

From: Geoff H Dean Geoff.Dean@tassie.net.au

This post is in response to the recent email by Tina (13 April), and the
general interest in estimates of the prevalence of trichotillomania.

I append a summary list, distilled from the recent article by F.I. Penzel
in Medscape Mental Health 5(1), 2000; and also the article by G.A.
Christenson and C.S. Mansueto in the book by D.J. Stein et al (1999)
"Trichotillomania".

This represents an extensive review of literature describing surveys of
prevalence. It can be readily seen that surveys have important differences
in the extent to which they apply the diagnostic criteria for
trichotillomania. For your reference I have appended these criteria.

One could argue, and some have, that the criteria are inappropriate ... but
that is another story, for another day.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Surveys for Prevalence of Trichotillomania

Anderson and Dean (1956), Number in the study (N)=500, Refer Penzel ref.=18
0.6% - Child guidance clinic

Schachter (1961), N=10,000, Refer Penzel ref=19
0.05% - Children with reported psychiatric disorders

Mannino and Delgado (1969), N=1368, Refer Penzel ref.=03
0.5% - Children seen at their Mental Health Study Center

Azrin and Nunn (1978), No study, Refer Penzel ref.=20
4% - Based on subjective impressions, not factual data

Christenson et al (1991), N=2579, Refer Stein p.6
0.6% - College students. Criteria strictly applied.
2.5% - Did not necessarily experience prior urges, or post-pulling relief
or gratification

Reeve et al (1992), N=10, Refer Penzel ref.=10
10% - Small sample

Rothbaum et al (1993), N=490, Refer Stein p.6
10% - Survey of University students. Reported "non-cosmetic hair-pulling"
on a regular basis.
2% - Reported resultant baldness or bald spots.
2% - Reported emotional distress as a result of pulling
1% - Reported regular pulling, and bald spots and distress

Rothbaum et al (sister study) (1993), N=221, Refer Stein p.6
13% - Survey of University students. Reported hair-pulling on a regular basis.
1% - Reported baldness or bald spots.
1% - Reported emotional distress as a result of pulling

Graber and Arndt (1993), N=98, Refer Stein p.7
11% - University undergraduates reporting hair-pulling; but there was no
clarification of the degree of hair loss or associated distress.

Graber and Arndt (1993), N=218, Refer Stein p.7
4% - Shopping center survey. People reported hair pulling but there was
no clarification of the degree of hair loss or associated distress.

Stanley et al (1994), N=288, Refer Stein p.6
15.3% - University students. Reported at least some hair pulling during the
year
3% - Reported at least some hair pulling on a daily basis, but no
visible hair loss was reported.

Stanley et al (1995), N=165, Refer Stein p.6
13.3% - University students. Non-clinical hair pulling, but it was unclear
to what extent the students would have met the criteria for trichotillomania.


TABLE 1-1. DSM-IV diagnostic criteria for trichotillomania [ex Stein, p.4]

A. Recurrent pulling out of one's hair resulting in noticeable hair loss.

B. An increasing sense of tension immediately before pulling out the hair
or when attempting to resist the behavior.

C. Pleasure, gratification, or relief when pulling out the hair.

D. The disturbance is not better accounted for by another mental disorder
and is not due to a general medical condition (e.g., a dermatological
condition).

E. The disturbance causes clinically significant distress or impairment
in social, occupational, or other important areas of functioning.

Source. Reprinted from Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition. Washington, DC, American Psychiatric Association,
1994. Copyright 1994, American Psychiatric Association.


And then Mike Grant had this interesting observation

From: MJGRANT@AOL.com
Subject: Re: TTM: Statistics

_______________________________________________________________________________

In a message dated 4/7/00 9:24:46 AM Central Daylight Time,
kristi@netrover.com writes:

<< I have a psychology degree so this all makes perfect sense to me. I was
wondering what other disorders you are speaking about above (if they have
been identified). >>

As you may know, the DSM-IV only recognizes a single classification of
trichotillomania. The problem will the diagnostic criteria in the DSM-IV is
that there are a great many hairpullers who do not fail within its
definition. So where does that leave those who pull there hair and do not
meet the DSM-IV definition of trichotillomania? In my years within the
hairpulling community, I have observed the following major subgroups. Again,
this is my own observation as a lay person.

Group One - Those that fall within the DSM-IV definition whose pulling is
best described as an Impulse Control Disorder. These individuals describe
having an urge to pull which they are unable to pull. There is no obessional
thinking which drives the pulling. The urge just comes at random and the
individual gives into it. This is no ritualistic behavior associated with
the pulling and the puller is completely aware of the actions. The pulled
hair has little or no interest to these pullers.

Group Two - Those whose pulling very closely an obsessive-compulsive
disorder. These individuals have obesssion thinking which drives the
behavior. These individuals talk about their pulling in terms of looking for
"bad" hairs or ones with large roots. After the hair is pull, the hair is
often examined and manipulated in a ritualistic fashion. These individual
tend to display obsessive-compulsive behaviors in other areas of their lives.
The pulling seems to be motivated by ideation more than a perceived
physical sensation such as an itch or tingling sensation.

Group Three - Those whose experience a tracelike state (zoning) while
pulling. Achieving this state of altered consciouness seems to be a
prerequisite for a pulling episode and the pulling seems to have a life of
its own outside the individual's control. These individuals do not exhibit
obessional ideation about their pulling ritualistic in nature. What
differentiates these individuals from the other non-OCD groups is the
trance-like state and autonomic action which seems to mimic in some ways a
tic or non-convulsive seizure disorder.

Group Four - Those whose pulling seems to resemble a simple habit. There are
no trance-like states, obession ideation, ritualistic behavior, autonomic
action, or irresistable itch-like or tingling sensation. These individuals'
pulling seem to be driven mostly by behavioral cues. The pulling tends to be
mostly situational. The remarkable thing about these individuals is that a
temporary change in lifestyle, such as a vacation or summer camp, often
brings about a near complete extinction of the pulling urge and behavior.

Group Five - Individuals in this group have a clearly demonstrable concurrent
dermatological condition. The skin is usually inflammation and there are
oftentimes lesions (bumps). These individuals show no OCD like
characteristics, trance-like states, and their the urge to pull is not
situational. These individual tend to pull only from very specific areas and
frequently complaint of "hot spots" or areas of intense itching. Individual
in this group tend to benefit greatly from address the concurrent
dermatological problem, even when no cause has been identified and only
palative treatment and symptomatic relief is given.

Group Six - Those who do not fall into any of the above categories. For
these individuals, pulling represents a source of considerable pleasure
and/or relief. These individuals tend to pull only under stress or when
bored. These individuals exhibit the highest level of control over their
pulling of all the groups. Because of what may be a pleasure seeking
component of their pulling, these individuals also seem to harbor the most
guilt over their behavior.

These are just my own personal classifications and are not intended to be
scientific. There are of course overlaps within these groups. However,
there are clearly mutual exclusive areas as well. I should also point out
that what may have initiating the pulling behavior may not be small as what
sustains it.

Take care.

Mike