DSM-V diagnostic criteria and classification of trichotillomania
Marta Ghisi, Gioia Bottesi
Trichotillomania consists in chronic hair-pulling and is currently classified by DSM-IV-TR under the
following category: «impulse control disorder not elsewhere classified». Recent studies suggest the
inadequacy of the diagnostic criteria; in particular, criteria B and C have been regarded as excessively
rigid and restrictive, as well as poor in predicting symptom severity and functional impairment
generally associated with this disorder. Therefore, the current diagnostic criteria hinder the clinician’s
work both at diagnostic and therapeutic levels. The current review focusses on the principal evidence
supporting the need to reconsider the diagnostic criteria adopted in clinical practice. Furthermore, the
most corroborated alternative diagnostic classifications proposed to-date were examined based on the
results of recent research. Lastly, particular attention has been paid to the proposals currently being
evaluated for DSM-V; these concern a series of variations in the diagnostic criteria and the possibility
of including trichotillomania in the following category: «body-focused repetitive behavioural
disorders» that would constitute the motoric subtype of the «obsessive-compulsive spectrum
disorders».
Keywords
Trichotillomania, diagnostic criteria, diagnostic classification, DSM-V, obsessivecompulsive
spectrum.
