McLean Hospital (MJM, LS, AFT, IV, AF), Belmont, MA.
McLean Hospital (MJM, LS, AFT, IV, AF), Belmont, MA.
Am J Geriatr Psychiatry. 2024 Jul;32(7):879-894. doi: 10.1016/j.jagp.2024.02.013. Epub 2024 Mar 7.
Excoriation disorder (ED) is defined as compulsive skin picking that results in skin damage and emotional distress. Optimal management of ED includes individualized treatment plans consisting of psychotherapies, behavioral and pharmacologic interventions. Compared with younger populations, older adults are at increased risk for poor outcomes, such as infection and hospitalization, and require unique management considerations. Risk factors that contribute to disease burden include age-related changes to the skin and underlying medical and psychiatric comorbidities. A literature review was conducted on ED yielding limited evidence exclusive to older adults. The authors suggest a therapeutic approach to ED in older adults based on available evidence and experience from inpatient and outpatient psychiatric settings. Finally, opportunities for future research are highlighted.
搔抓障碍(ED)定义为强迫性的皮肤搔抓,导致皮肤损伤和情绪困扰。ED 的最佳治疗包括个体化治疗计划,包括心理治疗、行为和药物干预。与年轻人群相比,老年人的预后较差,如感染和住院治疗的风险增加,需要特殊的管理考虑。导致疾病负担的危险因素包括与年龄相关的皮肤变化以及潜在的医学和精神共病。对 ED 的文献复习结果表明,专门针对老年人的证据有限。作者根据现有的证据和住院和门诊精神科环境的经验,提出了一种治疗老年人 ED 的方法。最后,还强调了未来研究的机会。