A systematic review and meta-analysis of psychiatric treatments for excoriation (skin-picking) disorder

Robert R. Selles, Joseph McGuire, Brent J. Small, Eric A. Storch

Research output: Contribution to journalArticle


Objective While individual trials suggest benefit of interventions for excoriation (skin-picking) disorder (ExD), limited systematic evaluation of treatments, or their collective benefit, exists. Methods The present study examined the current state of treatments for ExD in a systematic review and meta-analysis and explored potential treatment moderators. Twelve trials were identified for review, including five with a control condition. Of these, nine were eligible to be included in the meta-analysis (three with a control). Results A fixed-effects meta-analysis found a large overall treatment effect size (g = 1.13), comprised of large effects for behavioral treatments (g = 1.19), lamotrigine (g = 0.98) and selective serotonin reuptake inhibitors (g = 1.09). Clinician-rated measures did not significantly differ from self-rated measures; however, larger effects were observed on self-rated measures of severity, as compared to impairment [Q(1) = 4.63, P = .03]. Treatment type, trial length and trial methodological quality were not significant moderators. For controlled trials, the comparative efficacy of treatments for ExD was in the moderate range (g = 0.47). Conclusion Findings suggest that treatment for ExD has benefit; however, the meta-analysis did not provide strong evidence to support any specific treatment or to suggest its unique clinical benefit over control conditions. Overall, there is a lack of study on treatments for ExD and additional randomized controlled trials with inclusion of multiple informants in assessment is needed.

Original languageEnglish (US)
Pages (from-to)29-37
Number of pages9
JournalGeneral Hospital Psychiatry
StatePublished - Jul 1 2016
Externally publishedYes



  • Behavioral treatment
  • Excoriation disorder
  • Pharmacological treatment
  • Therapy

ASJC Scopus subject areas

  • Psychiatry and Mental health

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