BACKGROUND While Skin Picking Disorder (SPD) is a well-described neuropsychiatric disorder that causes severe stress and impairment, there is no clear protocol for treating patients and a relatively small body of literature evaluating treatment approaches. OBJECTIVE This review aims to summarize and compare recent publications and provide an up-to-date guide of current non-pharmacological treatments for SPD. METHODS A literature review was conducted on all non-pharmacological SPD treatment studies published between 2017-2023 using PubMed, CINAHL Plus with Full text (EBSCO), and Scopus. Search terms included skin picking, excoriation, psychiatry, treatment, and psychodermatology. Studies including SPD within other body-focused repetitive behaviors (BFRBs), studies using pharmacological agents, and studies not available in English were excluded. A minimum of 2 authors screened each abstract while blinded to minimize bias to assess for inclusion. RESULTS 11 studies (2068 participants) were included, with a variety of study designs including feasibility, randomized control trial, longitudinal cohort, multiple baseline experimental, naturalistic trial, and controlled single case design with multiple baseline studies. The treatments include cognitive behavioral therapy (CBT), Acceptance and Commitment Therapy (ACT), ACT-Enhanced Group Behavioral Therapy (AE-GBT), ACT-Informed Exposure Therapy, group therapy, psychotherapy, Repetitive Transcranial Magnetic Stimulation (rTMS), online self-help modules, and Expressive Writing (EW). Studies implementing CBT, Habit Reversal Therapy (HRT), AE-GBT, online self-help modules, and EW demonstrated the best results in treating SPD. CONCLUSION Several studies achieved significant outcomes for SPD participants, confirming the usefulness of non-pharmacological treatment in SPD. Based on our results, CBT, AE-GBT, online self-help modules, and EW appear to be the most effective in treating SPD. Additionally, most of these treatment modalities can be tailored to meet patient-specific needs. Some limitations of the studies include small sample sizes, lack of control groups/randomization, limited long-term follow-up data, and lack of gender variability.

中文翻译：

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皮肤采摘障碍 (SPD) 非药物治疗方案的系统评价。


背景虽然皮肤采摘障碍（SPD）是一种被充分描述的神经精神疾病，会导致严重的压力和损伤，但目前还没有明确的治疗患者方案，评估治疗方法的文献也相对较少。目的 本综述旨在总结和比较最近的出版物，并为当前 SPD 的非药物治疗提供最新指南。方法 使用 PubMed、CINAHL Plus 全文 (EBSCO) 和 Scopus 对 2017 年至 2023 年期间发表的所有非药物 SPD 治疗研究进行文献综述。搜索词包括皮肤采摘、表皮剥脱、精神病学、治疗和心理皮肤病学。包括其他以身体为中心的重复行为 (BFRB) 中的 SPD 的研究、使用药物的研究以及没有英文版本的研究被排除在外。至少有 2 位作者在不知情的情况下筛选每个摘要，以最大程度地减少评估纳入的偏差。结果 纳入 11 项研究（2068 名受试者），研究设计多种多样，包括可行性、随机对照试验、纵向队列、多基线实验、自然主义试验以及多基线研究的对照单病例设计。治疗包括认知行为疗法 (CBT)、接受与承诺疗法 (ACT)、ACT 增强团体行为疗法 (AE-GBT)、ACT 知情暴露疗法、团体疗法、心理疗法、重复经颅磁刺激 (rTMS)、在线疗法自助模块和表达性写作（EW）。实施 CBT、习惯逆转疗法 (HRT)、AE-GBT、在线自助模块和 EW 的研究证明了治疗 SPD 的最佳效果。 结论 多项研究为 SPD 参与者取得了显着的结果，证实了非药物治疗对 SPD 的有用性。根据我们的结果，CBT、AE-GBT、在线自助模块和 EW 似乎是治疗 SPD 最有效的方法。此外，大多数治疗方式都可以根据患者的具体需求进行定制。研究的一些局限性包括样本量小、缺乏对照组/随机化、长期随访数据有限以及缺乏性别变异。