DSM-5 field survey: Skin picking disorder
South African Medical Research Council, Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA, Department of Public Health, University of Copenhagen, Copenhagen, DenmarkDan J. Stein, MD, PhD
South African Medical Research Council, Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, South Africa
BACKGROUND: Pathologic skin picking (skin picking disorder [SPD]) is a prevalent and disabling condition, which has received increasing study. It is timely to consider including SPD in DSM-5. The aim of this field survey was to investigate possible diagnostic criteria for SPD.
METHODS: Patients age >10 with skin-picking symptoms were recruited. Patients were assessed with 2 modules based on the Structured Clinical Interview for DSM, which addressed proposed DSM-5 diagnostic criteria for SPD. Additional questions were included to test other possible diagnostic criteria.
RESULTS: Thirty-eight patients had SPD. All had recurrent skin picking that resulted in skin lesions. Skin picking persisted despite repeated attempts to decrease or stop. “Urges” or “needs” to pull were not endorsed by all patients, but did correlate with severity of skin picking. “Resistance” to picking also was not universally endorsed.
CONCLUSIONS: These data support the proposed DSM-5 diagnostic criteria for SPD. Although most patients have urges to pick or a sense of relief when picking, such phenomena are not universal and should not be included in the diagnostic criteria set. An additional criterion of repeated attempts to decrease or stop skin picking seems warranted.
KEYWORDS: skin picking disorder, diagnostics, DSM-5
ANNALS OF CLINICAL PSYCHIATRY 2012;24(4):300-304CORRESPONDENCE: Christine Lochner, PhD, PO Box 19063, Tygerberg 7507 South Africa E-MAIL: firstname.lastname@example.orgAnnals of Clinical Psychiatry ©2012 Frontline Medical Communications.