Psychiatric Characteristics and Quality of Life in Patients with Pathologic Skin Picking
-
Ali Akbar Nejatisafa
,
Mohammad Reza Mohammadi
,
Kamran Balighi
,
Vahid Farnia
,
Mohammad Arbabi
,
katayoon Yazdchi
Abstract
Objective: This study aimed to detail the phenomenology and psychiatric comorbidities in patients with pathologic skin picking (PSP).
Method: Forty five subjects (30% males) with PSP (mean S.D. =33.210.9) were assessed. Subjects were assessed for psychiatric co morbidity using General Health Questionnaire (GHQ). The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess obsessive compulsive symptoms; the Dermatology quality of life index(DLQI) was utilized to evaluate the quality of life in patients; and clinical severity using Visual Analogue Scale(VAS) was employed for evaluating skin picking behavior.
Results: The mean time after (S.D.) the onset of PSP was 6.62.4years.Twenty eight (62.2%) individuals had a bimodal GHQ score higher than five which implied probable mental disorder, and twenty two (48.9%) of the individuals with PSP had significant obsessive compulsive disorder. The severity of impairment of quality of life status was increased with increment of mental disorder severity.
Conclusion: PSP appears to be time consuming and frequently associated with psychiatric co morbidities. Considerations should be made on the relationship between psychiatric co morbidity and quality of life in PSP diagnosis and treatment of mental disorders.
Arnold LM, Auchenbach MB,McElroy SL. Psychogenic excoriation. Clinical features, proposed diagnostic criteria, epidemiology and approaches to treatment. CNS Drugs 2001; 15: 351-359.
Flessner CA,Woods DW. Phenomenological Characteristics, Social Problems, and the Economic Impact Associated With Chronic Skin Picking. Behav Modif 2006; 30: 944.
Swedo SE,Rapoport JL. Annotation: trichotillomania. J Child Psychol Psychiatry 1991; 32: 401-409.
Keuthen NJ, Deckersbach T, Wilhelm S, Hale E, Fraim C, Baer L, et al. Repetitive skin- picking in a student population and comparison with a sample of self-injurious skin-pickers. Psychosomatics 2000; 41: 210- 215.
Griesemer R. Emotionally triggered disease in a dermatology practice. Psychiatr Ann 1978; 8: 407-412.
Gupta MA, Gupta AK,Haberman HF. The self- inflicted dermatoses: a critical review. Gen Hosp Psychiatry 1987; 9: 45-52.
Grant JE, Williams KA,Potenza MN. Impulse- control disorders in adolescent psychiatric inpatients: co-occurring disorders and sex differences. J Clin Psychiatry 2007; 68: 1584- 1592.
Grant JE, Menard W,Phillips KA. Pathological skin picking in individuals with body dysmorphic disorder. Gen Hosp Psychiatry 2006; 28: 487-493.
Odlaug BL,Grant JE. Clinical characteristics and medical complications of pathologic skin picking. Gen Hosp Psychiatry 2008; 30: 61-66.
Bienvenu OJ, Samuels JF, Riddle MA, Hoehn- Saric R, Liang KY, Cullen BA, et al. The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry 2000; 48: 287- 293.
Cullen BA, Samuels JF, Bienvenu OJ, Grados M, Hoehn-Saric R, Hahn J, et al. The relationship of pathologic skin picking to obsessive-compulsive disorder. J Nerv Ment Dis 2001; 189: 193-195.
Bohne A, Keuthen N,Wilhelm S. Pathologic hairpulling, skin picking, and nail biting. Ann Clin Psychiatry 2005; 17: 227-232.
Arnold LM, McElroy SL, Mutasim DF, Dwight MM, Lamerson CL,Morris EM. Characteristics of 34 adults with psychogenic excoriation. J Clin Psychiatry 1998; 59: 509-514.
Odlaug BL,Grant JE. Childhood-onset pathologic skin picking: clinical characteristics and psychiatric comorbidity. Compr Psychiatry 2007; 48: 388-393.
Wilhelm S, Keuthen NJ, Deckersbach T, Engelhard IM, Forker AE, Baer L, et al. Self- injurious skin picking: clinical characteristics and comorbidity. J Clin Psychiatry 1999; 60: 454-459.
O'Sullivan RL, Phillips KA, Keuthen NJ,Wilhelm S. Near-fatal skin picking from delusional body dysmorphic disorder responsive to fluvoxamine. Psychosomatics 1999; 40: 79-81.
Grant JE, Odlaug BL,Kim SW. Lamotrigine treatment of pathologic skin picking: an open- label study. J Clin Psychiatry 2007; 68: 1384- 1391.
Aghaei S, Sodaifi M, Jafari P, Mazharinia N,Finlay AY. DLQI scores in vitiligo: reliability and validity of the Persian version. BMC Dermatol 2004; 4:8.
Noorbala AA, Bagheri Yazdi SA, Yasamy MT,Mohammad K. Mental health survey of the adult population in Iran. Br J Psychiatry 2004; 184: 70-73.
Picardi A, Abeni D, Melchi CF, Puddu P,Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Br J Dermatol 2000; 143: 983-991.
Hughes JE, Barraclough BM, Hamblin LG,White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry 1983; 143: 51-54.
American Psychiatric Association . Diagnostic and statistical manual of mental disorders,text revision (DSM-IV-TR). 4th ed. Washington , DC: American Psychiatric Publishing, Inc; 2000.
Fontenelle LF, Mendlowicz MV,Versiani M. Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci 2005; 59: 30-37.
Grant JE,Potenza MN. Compulsive aspects of impulse-control disorders. Psychiatr Clin North Am 2006; 29: 539-551, x.
Hanna GL, Fischer DJ, Chadha KR, Himle JA,Van Etten M. Familial and sporadic subtypes of early-onset Obsessive- Compulsive disorder. Biol Psychiatry 2005; 57: 895-900.
Matsunaga H, Kiriike N, Matsui T, Oya K, Okino K,Stein DJ. Impulsive disorders in Japanese adult patients with obsessive- compulsive disorder. Compr Psychiatry 2005; 46: 43-49.
Stein DJ,Hollander E. Dermatology and conditions related to obsessive-compulsive disorder. J Am Acad Dermatol 1992; 26: 237- 242.
Samuels JF, Riddle MA, Greenberg BD, Fyer AJ, McCracken JT, Rauch SL, et al. The OCD collaborative genetics study: methods and sample description. Am J Med Genet B Neuropsychiatr Genet 2006; 141B: 201-207.
Shepherd M, Cooper M, Brown AC,Graham K. Psychiatric Illness in Primary Care. Oxford: Oxford University Press; 1966.
Goldberg D,Huxley P. Mental Illness in the community.The pathway to Psychiatric Care. London: Tavistock Publications; 1980.
Hawton K. The long-term outcome of psychiatric morbidity detected in general medical patients. J Psychosom Res 1981; 25: 237-243.
Johnstone A,Goldberg D. Psychiatric screening in general practice. A controlled trial. Lancet 1976; 1: 605-608.
Stein DJ, Chamberlain SR,Fineberg N. An A- B-C model of habit disorders: hair-pulling, skin- picking, and other stereotypic conditions. CNS Spectr 2006; 11: 824-827.
Teng EJ, Woods DW,Twohig MP. Habit reversal as a treatment for chronic skin picking: a pilot investigation. Behav Modif 2006; 30: 411-422.
| Files | ||
| Issue | Vol 3 No 1 (2008) | |
| Section | Articles | |
| Keywords | ||
| Comorbidity Neurodermatitis Psychiatry Quality of life Skin disease | ||
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