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Epidemiology and Comorbidities of Excoriation Disorder: A Retrospective Case-Control Study
Christina Kwon1, Nishadh Sutaria1, Raveena Khanna1
1Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Journal of Clinical Medicine
|August 23, 2020
Summary
Excoriation disorder patients often have co-occurring psychiatric conditions like OCD and depression. Many patients do not receive or follow through with psychiatric referrals, leading to poor symptom outcomes.
Area of Science:
- Psychiatry
- Dermatology
- Epidemiology
Background:
- Excoriation disorder is a psychocutaneous condition marked by repetitive skin picking.
- Significant morbidity is associated with excoriation disorder.
- Epidemiological data for excoriation disorder patients are limited.
Purpose of the Study:
- To characterize patient demographics and comorbidities in excoriation disorder.
- To identify common psychiatric conditions associated with excoriation disorder.
- To evaluate treatment referral and follow-up rates and symptom outcomes.
Main Methods:
- Retrospective case-control study.
- 250 patients with excoriation disorder compared to 250 matched controls.
- Data collected between 2007 and 2019 at a tertiary care center.
Main Results:
- Excoriation disorder patients were predominantly female (76%), Caucasian (82%), and unmarried (62%), with a mean age of 49.
- Increased odds of psychiatric comorbidities including OCD, substance use disorder, PTSD, depression, bipolar disorder, ADHD, and anxiety were observed.
- Low rates of psychiatry referrals (42%) and follow-up (36% of referred), with only 21% experiencing symptom resolution.
Conclusions:
- Excoriation disorder is strongly associated with numerous psychiatric comorbidities.
- Current management pathways show low referral and follow-up rates, contributing to unfavorable outcomes.
- A multidisciplinary approach involving dermatology and psychiatry is essential for effective management.
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