Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, 9th Floor, New York, NY, 10021, USA.
Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA.
Am J Clin Dermatol. 2018 Dec;19(6):887-891. doi: 10.1007/s40257-018-0386-1.
Onychophagia, defined as habitual nail biting, is a common disorder affecting 6-45% of the population and is more prevalent in children.
Our primary objective was to determine the prevalence of nail biting in the pediatric population. Secondary objectives were to assess the presence of psychiatric co-morbidities associated with nail biting, and the effect of treatment on nail biting.
An anonymous voluntary survey was administered to participants at an outpatient academic pediatric clinic at Weill Cornell Medicine. Age, sex, psychiatric diagnosis, treatment sought, family history, and frequency of nail biting were analyzed across 282 enrolled patients aged 3-21 years. One patient was subsequently excluded due to incomplete data.
Of 281 patients, 101 (37%) reported past or present nail biting lasting more than a month. Median age of onset was 5 years old (range 1-13 years). A significantly higher percentage of biters (18%; 19/104) than non-biters (6%; 11/177) were diagnosed with a psychiatric disorder (p < 0.01). Amongst biters, concurrent fingernail and toenail involvement was much less common (12%; 12/104) than that of fingernails alone (88%; 92/104). However, the ratio of fingernail and toenail biters to fingernail biters alone was greater in those with psychiatric diagnosis (0.36) than without (0.09) (p = 0.07).
Our study highlights behavioral patterns as well as familial, psychiatric, and other factors associated with pediatric nail biting. Familiarity with such factors, the clinical presentation of onychophagia, and available treatment options may aid in reducing its severity in affected patients and overall prevalence.
咬指甲癖，即习惯性咬指甲，是一种常见的疾病，影响 6%-45%的人群，在儿童中更为常见。
我们的主要目的是确定儿科人群中咬指甲的流行率。次要目的是评估与咬指甲相关的精神共病的存在，以及治疗对咬指甲的影响。
我们在 Weill Cornell Medicine 的一家门诊儿科诊所对参与者进行了匿名自愿调查。分析了 282 名年龄在 3-21 岁的入组患者的年龄、性别、精神科诊断、寻求的治疗、家族史和咬指甲频率。由于数据不完整，有 1 名患者随后被排除在外。
在 281 名患者中，有 101 名（37%）报告过去或现在有持续超过一个月的咬指甲行为。发病年龄中位数为 5 岁（范围 1-13 岁）。咬指甲者（18%，19/104）比非咬指甲者（6%，11/177）更有可能被诊断为精神疾病（p<0.01）。在咬指甲者中，同时累及手指甲和脚趾甲的情况要少得多（12%，12/104），而仅累及手指甲的情况更为常见（88%，92/104）。然而，有精神科诊断的咬指甲者中同时累及手指甲和脚趾甲的比例（0.36）高于无精神科诊断的咬指甲者（0.09）（p=0.07）。
我们的研究强调了与儿科咬指甲相关的行为模式以及家族、精神和其他因素。熟悉这些因素、咬指甲的临床表现和可用的治疗选择可能有助于减轻受影响患者的严重程度和总体流行率。
