Clinical Classification of Trichotillomania

Diagnostic and Statistical Manual of Mental Disorders (DSM)

Diagnostic and Statistical Manual of Mental Disorders (DSM)

When working with patients, health professionals often refer to clinical diagnostic manuals to better understand the patient’s illness and potential treatment.

There are two main recognised diagnostic manuals commonly used around the world today. These are the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) (the latest of which is pictured)  Whilst both manuals generally tend to complement each other, there are differences in the descriptions they use.

You can read a summary of both the ICD and DSM on our clinical classification of OCD page. On this page we will summarise what both diagnostic manuals say about Trichotillomania.


OCD-UK Note: In the current International Classification of Diseases (ICD-10) Trichotillomania is listed under the sub-category of ‘Habit and impulse disorders‘ (code: F63), which is listed under the main category of ‘Disorders of adult personality and behaviour‘ (code: 60) which fits under the broader category of ‘Mental and behavioural disorders’.
The category of Habit and impulse disorder (F63) also includes:

  • F63.0 – Pathological gambling
  • F63.1 – Pathological fire-setting [pyromania]
  • F63.2 – Pathological stealing [kleptomania]
  • F63.3 – Trichotillomania

At present it states the following diagnostic criteria for Trichotillomania (F63.3):

A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination.

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