Near-Fatal Skin Picking From Delusional Body Dysmorphic Disorder Responsive to Fluvoxamine
1999; Elsevier BV; Volume: 40; Issue: 1 Linguagem: Inglês
10.1016/s0033-3182(99)71276-4
ISSN1545-7206
AutoresRichard O’Sullivan, Katharine A. Phillips, Nancy J. Keuthen, Sabine Wilhelm,
Tópico(s)Obsessive-Compulsive Spectrum Disorders
ResumoReceived September 17, 1996; revised September 25, 1996; accepted May 21, 1997. From the Psychiatric Neuroscience Program, Massachusetts General Hospital–East CNY–9, Harvard Medical School, Charlestown, Massachusetts; and Butler Hospital and the Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, Rhode Island. Address correspondence and reprint requests to Dr. O’Sullivan, Massachusetts General Hospital, Department of Psychiatry, Bldg. 149, 13th Street, Charlestown, MA 02129. Copyright 1999 The Academy of Psychosomatic Medicine. Skin picking as a manifestation of psychopathology, while an underrecognized problem, is receiving increased attention in the medical and psychiatric literature. Sometimes described as neurotic excoriations, skin picking is a relatively frequent manifestation of body dysmorphic disorder (BDD), a distressing or impairing preoccupation with a minimal or nonexistent defect in one’s appearance. Skin picking also occurs in other psychiatric disorders, including trichotillomania and obsessivecompulsive disorder (OCD), as well as various medical and developmental conditions. Morbidity may be considerable, including psychological distress, skin infections, scarring, and surgical intervention. Many of these patients first present for treatment to a primary care physician, dermatologist, or surgeon, rather than a psychiatrist. We report a case of severe skin picking attributable to delusional BDD, which resulted in considerable medical morbidity and a nearly fatal outcome. To our knowledge, this is the first report of decreased skin picking in delusional BDD with fluvoxamine.
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