Skin picking disorder: Prevalence, correlates, and associations with quality of life in a large sample

Myrela O. Machado, Cristiano A. Köhler, Brendon Stubbs, Paulo R. Nunes-Neto, Ai Koyanagi, João Quevedo, Jair C. Soares, Thomas N. Hyphantis, Donatella Marazziti, Michael Maes, Dan J. Stein, André F. Carvalho

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objective Evidence suggests that skin picking disorder (SPD) could be a prevalent condition associated with comorbidity and psychosocial dysfunction. However, just a few studies have assessed the prevalence and correlates of SPD in samples from low-and middle-income countries. In addition, the impact of SPD on quality of life (QoL) dimension after multivariable adjustment to potential confounders remains unclear.Methods Data were obtained from a Brazilian anonymous Web-based research platform. Participants provided sociodemographic data and completed the modified Skin Picking-Stanford questionnaire, the Hypomania Checklist (HCL-32), the Patient Health Questionnaire-9 (PHQ-9), the Fagerström Test for Nicotine Dependence, Alcohol Use Disorder Identification Test (AUDIT), Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report-short form, and the World Health Organization quality of life abbreviated scale (WHOQOL-Bref). Associations were adjusted to potential confounders through multivariable models.Results For our survey, 7639 participants took part (71.3% females; age: 27.2±7.9 years). The prevalence of SPD was 3.4% (95% CI: 3.0-3.8%), with a female preponderance (P<0.001). In addition, SPD was associated with a positive screen for a major depressive episode, nicotine dependence, and alcohol dependence, as well as suicidal ideation. Physical and psychological QoL was significantly more impaired in participants with SPD compared to those without SPD, even after adjustment for comorbidity.Conclusions In this large sample, SPD was a prevalent condition associated with co-occurring depression, nicotine, and alcohol dependence. In addition, SPD was independently associated with impaired physical and psychological QoL. Public health efforts toward the early recognition and treatment of SPD are warranted.

Original languageEnglish
Pages (from-to)311-320
Number of pages10
JournalCNS Spectrums
Issue number5
StatePublished - 1 Oct 2018
Externally publishedYes


  • Epidemiology
  • obsessive-compulsive related disorders
  • psychiatry
  • quality of life
  • skin picking disorder


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