■以身体为中心的重复行为(BFRB;例如,皮肤采摘)涵盖了皮肤病学和精神病学/心理学的一系列条件。该疾病很普遍,但目前未被诊断和治疗不足。
■要比较新的自助干预措施,习惯替代,针对BFRB治疗的等待名单控制条件。
■这项随机临床试验于2022年在线进行。参与者是基于人群的BFRB非临床样本,并通过社交媒体招募。最初,481人进入评估;213人被排除在结果之外。268名参与者的最终样本被随机分配。干预期为6周。
■参与者被随机分配到自助干预,习惯替代,或等待列表控制条件(每个n=134)。
■通用BFRB量表-45(GBS-45,自我报告)代表了主要结果。
■两种情况下的个人(n=268;241[89.9%]女性;平均[SD]年龄,36.8[11.1]年;剥皮,68.3%;毛滴虫,28.4%;咬指甲,36.6%;唇颊咬,26.1%;其他,20.1%)在任何基线特征上没有差异。实验组在两种方案的主要结局(GBS-45)上显着改善(每周至少使用一次技术,ηp2=0.068,P=.001)和相对于等待名单对照组的意向治疗分析(期望最大化算法;ηp2=0.019,P=.02)。组和时间的相互作用仅在患者健康问卷-9和生活质量上产生了有利于实验条件的统计趋势。对于临床总体印象量表,习惯替代组中更多的个体报告改善(52.8%vs19.6%;P<.001).习惯替代组的用户满意度较高。包括所有基线变量的适度分析表明,那些表现出咬指甲的人特别受益于这项新技术。
■当前的概念验证随机临床试验初步证明,习惯替代是针对BFRB的可行且有效的自助策略,尤其是咬指甲.研究的局限性包括缺乏外部评估和经过验证的诊断。此外,这项研究缺少随访数据.自助习惯替代显示出减少BFRBs的希望,但不会伴随症状。
■德国临床试验注册标识符:DRKS00030511。
Body-focused repetitive behaviors (BFRBs; eg, skin picking) encompass a set of conditions at the interface of dermatology and psychiatry/psychology. The disorder is prevalent but currently underdiagnosed and undertreated.
To compare a new self-help intervention, habit replacement, against a wait-list control condition for the treatment of BFRBs.
This randomized clinical
trial was conducted online in 2022. Participants were a population-based nonclinical sample with BFRBs and were recruited via social media. Initially, 481 individuals entered the assessment; 213 were excluded blind to results. A final sample of 268 participants were randomized. The intervention period was 6 weeks.
Participants were randomized to a self-help intervention, habit replacement, or a wait-list control condition (each n = 134).
The Generic BFRB Scale-45 (GBS-45, self-report) represented the primary outcome.
Individuals in the 2 conditions (n = 268; 241 [89.9%] women; mean [SD] age, 36.8 [11.1] years; skin picking, 68.3%;
trichotillomania, 28.4%; nail biting, 36.6%; lip-cheek biting, 26.1%; other, 20.1%) did not differ on any baseline characteristics. The experimental group significantly improved on the primary outcome (GBS-45) for both the per-protocol (technique was used at least once weekly, ηp2 = 0.068, P = .001) and the intention-to-treat analyses relative to the wait-list control group (expectation-maximization algorithm; ηp2 = 0.019, P = .02). The interaction of group and time yielded statistical trends in favor of the experimental condition only on the Patient Health Questionnaire-9 and quality of life. For the Clinical Global Impressions scale, more individuals in the habit replacement group reported improvement (52.8% vs 19.6%; P < .001). User satisfaction in the habit replacement group was high. Moderation analyses that included all baseline variables showed that those who exhibited nail biting particularly benefited from the new technique.
The present proof-of-concept randomized clinical
trial tentatively demonstrates that habit replacement is a feasible and effective self-help strategy against BFRBs, especially for nail biting.
Study limitations include the lack of external assessment and verified diagnoses. In addition, the
study is missing follow-up data. Self-help habit replacement shows promise in reducing BFRBs but not concomitant symptoms.
German Clinical Trials Register Identifier: DRKS00030511.