Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Braz J Psychiatry. 2020 Sep-Oct;42(5):510-518. doi: 10.1590/1516-4446-2019-0636.
Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2).
The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint.
The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen's d: group = 0.88; individual = 1.15) (Study 2).
The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats.
NCT03182478.
虽然行为疗法可以有效地治疗皮肤搔抓障碍（SPD），但目前尚无改善 SPD 及其共病的标准化治疗方法，也没有团体干预措施。本试验旨在改编 Rothbaum 拔毛癖方案以用于 SPD（研究 1），并测试其对个体和团体格式治疗 SPD 和共病的疗效（研究 2）。
改编后的方案应用于 16 名 SPD 患者，他们被分配到团体或个体治疗（研究 1）。之后，54 名患者被随机分配到个体（n=27）或团体（n=27）治疗（研究 2）。在两项研究中，在基线和终点时评估 SPD 严重程度、焦虑、抑郁、临床状况和皮肤损伤严重程度。
改编后的方案在两种治疗方式（研究 1）中均可行，并导致高 SPD 缓解率（个体 63%；团体 52%），干预类型之间无显著差异（p = 0.4）（研究 2）。治疗后 SPD、焦虑和抑郁症状以及客观的患者损伤指标均得到改善。两种治疗方式的 SPD 症状改善均具有较大的效应量（Cohen's d：团体=0.88；个体=1.15）（研究 2）。
改编的 Rothbaum 方案在个体和团体治疗中对 SPD 缓解、共病和皮肤损伤均有效。
NCT03182478。
