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A healing herd
Published in Stacy K. Nakell, Treatment for Body-Focused Repetitive Behaviors, 2023
Though the value of group support is evident, few studies have explored the possible benefits of therapist-led group therapy in BFRBD treatment. A 2006 study compared the effectiveness of two kinds of therapist-led groups: skill-building and support groups, each with 12 members. The stated goal of treatment was alleviation of symptoms. Neither group was found to be particularly helpful toward achieving the desired long-term symptom relief (Diefenbach et al., 2006). Research in 2019 comparing support groups with psychodrama groups to treat excoriation disorder, with around 10 members per group, found that both types of groups were effective to the same extent at reducing skin-picking behaviors. This outcome pointed to the peer support element rather than psychodrama as the key change agent (Gulassa et al., 2019). The authors note that emotional dysregulation was a commonly identified trigger for skin picking and suggest that future groups focus on the enhancement of emotional regulation skills.
Case-Based Differential Diagnostic Mental Health Evaluation for Adults
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
Obsessive-compulsive disorder (OCD) is characterized by the presence of (1) obsessions, which are recurrent, persistent, and intrusive thoughts, urges, or images; and (2) compulsions, which are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. A person with OCD may have an obsession, a compulsion, or both (APA, 2013). There are a variety of OCD-related disorders, such as body dysmorphic disorder, hoarding disorder, trichotillomania (hair pulling), and excoriation disorder (skin picking). OCD is the fourth most common psychiatric disorder, and the lifetime prevalence of OCD in the general US population is estimated at 1–3%. The mean age of onset is approximately 20 years, and among adults, women are affected at a slightly higher rate than are men. Approximately 50–70% of clients with OCD have a sudden onset of symptoms following a stressful event, such as the death of a loved one, a serious illness, or a sexual problem (Sadock et al., 2019). Many OCD clients have full insight that their behaviors are senseless and excessive.
Psychocutaneous Disorders
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Kristen Russomanno, Vesna M. Petronic-Rosic
Final comment: Excoriation disorder is classified as an obsessive-compulsive and related disorder that is characterized by the conscious, repetitive, and poorly controlled desire to pick the skin, which ultimately results in significant distress for affected patients. Diagnosis requires the exclusion of other dermatoses. The condition is chronic, and a combination of pharmacologic and nonpharmacologic approaches may be used to address both psychologic and cutaneous components.
Current and up-and-coming pharmacotherapy for obsessive-compulsive disorder in adults
Published in Expert Opinion on Pharmacotherapy, 2018
Giacomo Grassi, Stefano Pallanti
NAC is a precursor of cysteine and modulates the cystine-glutamate antiporter and has both glutamate-modulating and antioxidant effects [41]. While two controlled studies showed clear benefits of NAC for trichotillomania and excoriation disorder [42,43], results are less consistent for OCD. Up to date, 5 randomized-controlled trails have been conducted on NAC augmentation of serotonergic treatment in patients with OCD with a NAC dose ranging from 2 to 3/g per day and a treatment period ranging from 10 to 12 weeks. Two out of five trials did not find any significant positive effect [44,45] while three trials showed a significant positive effect on OCD symptoms vs placebo [46–48]. Thus, NAC efficacy on patients with OCD remains inconclusive and larger multicenter randomized trials are needed.
Review of epidemiology, clinical presentation, diagnosis, and treatment of common primary psychiatric causes of cutaneous disease
Published in Journal of Dermatological Treatment, 2018
J. A. Krooks, A. G. Weatherall, P. J. Holland
The DSM-5 groups OCD and obsessive-compulsive-related disorders (OCRDs) into the same chapter due to their overlap in diagnostic symptoms and comorbidity (20). Indeed, due to their comorbidity, clinicians should screen for other disorders in this category in patients already diagnosed with one or more related conditions (Table 4) (20). Specific disorders include OCD, body dysmorphic disorder (BDD), hoarding disorder, body-focused repetitive behavior disorders (BFRBDs), substance/medication-induced OCRD, OCRD due to another medical condition, and other specified OCRD and unspecified OCRD (20). Disorders in this category that most commonly present to dermatologists include olfactory reference syndrome (ORS); BDD; and BFRBD’s, particularly excoriation disorder (ExD), and trichotillomania (TTM).
Choosing the appropriate pharmacotherapy for obsessive-compulsive disorder in adult patients with comorbid anxiety disorders: clinical and nosological considerations
Published in Expert Opinion on Pharmacotherapy, 2019
The Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) sets obsessive-compulsive disorder (OCD) and its related disorders (OCRDs), namely, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder, apart from the anxiety disorders (ADs), including generalized anxiety disorder (GAD), specific phobia, social anxiety disorder (SAD), agoraphobia, and panic disorder (PD) [1].