Akademik Veri Yönetim Sistemi
12 th International Congress on Psychopharmacology & 8 th International Symposium on Child and Adolescent Psychopharmacology, Antalya, Türkiye, 17 - 20 Kasım 2021, ss.178
0382 - A case of the treatment of skin picking disorder of a patient with mental retardation
Hicran Doğru, Halime İpek
Department of Child and Adolescent Psychiatry, Atatürk University, Erzurum, Turkey
ABSTRACT
INTRODUCTION:Skin picking disorder is a condition characterized by excessive picking behavior that is the recurrent excoriation of one’s own
skin, resulting in noticeable skin damage. Skin picking(SP) disorder did not appear as a separate diagnostic category in DSM-5 classification
systems, but it was included as an independent diagnosis in the Obsessive-Compulsive and Related Disorders category in DSM-5. Selective
serotonin reuptake inhibitors have been shown to be effective in the treatment of skin picking disorder in the case of reports, open-label studies
and double-blind studies. In our study, the improvement in the findings with fluvoxamine treatment in a male patient with open wounds on both
lower extremities was discussed (1)
CASE PRESENTATION:A 13-year-old male patient with mild mental retardation who lives with his family was admitted to our outpatient
department of child psychiatry with complaints of inattention, hyperactivity, behavioral problems and excessive SP of the front-legs for a-longtime. Atomoxetine and aripiprazole treatment was started for attention-deficit and hyperactivity disorder and conduct disorder (CD). The doses
were titrated respectively as follows; 60 mg/day, 25 mg/day. Therapy techniques could not be performed because of mild mental retardation
and impulsivity problems. Although complaints related to ADHD and CD regressed with atomoxetine and aripiprazole treatment, complaints
related to SP did not regress, and fluvoxamine treatment was started on the patient. The patient was started on fluvoxamine 50 mg/day and
titrated to 100 mg/day one week later. A significant improvement was observed in the patient's complaints after two months. The Clinical Global
Impressions(CGI) scale was performed, and Severity of illness: (CGI-S:6); Global Improvement (CGI-I:2 ); Efficacy index(none). (2-3)
CONCLUSIONS:Individuals with compulsive SP often have poor impulse control and results in important functional deterioration. They reported
shame, along with the avoidance of social situations. Fluvoxamine should be kept in mind in the treatment of these patients.
Keywords: psychogenic skin excoriation,self-injurious behavior, skin picking disorder.