Health Care Utilization Following First-Documented Trichotillomania Diagnosis in Adults: A Propensity Score–Matched Cohort Study

Background: Trichotillomania is associated with psychiatric comorbidity, but downstream health care utilization after diagnosis is less well characterized. <br><br>Methods: We conducted a retrospective propensity score–matched cohort study using de- identified electronic health record data. Adults with first-documented trichotillomania from 2017 to 2023 were matched 1:1 to controls on age, sex, and race. Primary outcomes were all-cause inpatient admission and emergency department utilization within 1 year. <br><br>Results: Matched cohorts included 24,997 adults with trichotillomania and 24,997 controls. Trichotillomania was associated with higher 1-year inpatient utilization (8.16% vs 4.60%; hazard ratio [HR], 1.94; 95% CI, 1.78-2.12; P&lt;.001) and emergency department utilization (9.59% vs 7.29%; HR, 1.42; 95% CI, 1.31-1.54; P&lt;.001). Secondary analyses showed higher anxiety, depressive disorder, and obsessive-compulsive disorder incidence. <br><br>Conclusions: First-documented trichotillomania was associated with increased short-term health care utilization, suggesting it may mark broader psychiatric and medical vulnerability.