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Pediatric Onychophagia: A Survey-Based Study of Prevalence, Etiologies, and Co-Morbidities
Abstract
Background
Onychophagia, defined as habitual nail biting, is a common disorder affecting 6–45% of the population and is more prevalent in children.
Objectives
Our primary objective was to determine the prevalence of nail biting in the pediatric population. Secondary objectives were to assess the presence of psychiatric co-morbidities associated with nail biting, and the effect of treatment on nail biting.
Methods
An anonymous voluntary survey was administered to participants at an outpatient academic pediatric clinic at Weill Cornell Medicine. Age, sex, psychiatric diagnosis, treatment sought, family history, and frequency of nail biting were analyzed across 282 enrolled patients aged 3–21 years. One patient was subsequently excluded due to incomplete data.
Results
Of 281 patients, 101 (37%) reported past or present nail biting lasting more than a month. Median age of onset was 5 years old (range 1–13 years). A significantly higher percentage of biters (18%; 19/104) than non-biters (6%; 11/177) were diagnosed with a psychiatric disorder (p < 0.01). Amongst biters, concurrent fingernail and toenail involvement was much less common (12%; 12/104) than that of fingernails alone (88%; 92/104). However, the ratio of fingernail and toenail biters to fingernail biters alone was greater in those with psychiatric diagnosis (0.36) than without (0.09) (p = 0.07).
Conclusions
Our study highlights behavioral patterns as well as familial, psychiatric, and other factors associated with pediatric nail biting. Familiarity with such factors, the clinical presentation of onychophagia, and available treatment options may aid in reducing its severity in affected patients and overall prevalence.
... Several studies investigating onychophagia have shown an association with other coexisting psychiatric conditions [6,[8][9][10]. In a study of 63 nail biters, ages 5 to 18 years, who were referred to a child and adolescent mental health clinic, attention deficit hyperactive disorder (74.6%), oppositional defiant disorder (36%), separation anxiety disorder (20.6%), enuresis (15.6%), tic disorder (12.7%), and OCD (11.1%) were the most common conditions associated with onychophagia [6]. ...
... There is thought to be a strong genetic component. One survey-based study of 281 participants at an outpatient pediatric clinic, ages 3 to 21, reported that a majority (63%) of nail-biting patients had at least one family member with onychophagia [9]. Similarly, the previously mentioned survey-based study analyzing mental health and nail-biting habits in 743 children reported that 55.8% of nail biters with one or more siblings had at least one sibling or parent who bit their nails frequently [8]. ...
... Onychophagia usually occurs in the fingernails, as toenails are rarely bitten [3]. Because toenails are physically harder to bite compared to fingernails, toenail biting suggests possible psychiatric comorbidities [9]. ...
Onychophagia (nail biting) and onychotillomania (nail picking) are chronic nail conditions categorized as body-focused repetitive behavior (BFRB) disorders. Due to a limited awareness of their clinical presentations, embarrassment on the part of patients, and/or comorbid psychiatric conditions, these conditions are frequently underrecognized and misdiagnosed. This article reviews the prevalence, etiology, diagnostic criteria, historical and physical exam findings, and treatment options for these conditions. The PubMed/MEDLINE database was searched for relevant articles. Onychophagia and onychotillomania are complex disorders necessitating a detailed patient history and physical examination and a multidisciplinary treatment approach for successful diagnosis and management. Due to the dearth of clinical trials for treatment of nail biting and nail picking, large clinical trials are necessary to establish standardized therapies.
... More commonly, it is referred to as nail biting. Onychophagia is defined as biting on the nails (of either the digits of the hand or feet or both) with the teeth after putting one or more fingers, thumbs, and/or toes into the mouth [3,4,12,16]. ...
... The prevalence reached a peak in adolescence and decreased after puberty; indeed, the behavior is discontinued by many children as they become older. However, adult-onset onychophagia can occur [3,4,12,16]. ...
... Monozygotic twins have a higher concordance rate of nail biting as compared to dizygotic twins. Also, onychophagia occurs more often in individuals who have a parent that bites their nails; hence, after diagnosing onychophagia, particularly in a pediatric patient, it might be reasonable to check the nails of other family members for nail biting [3,4,12,16]. ...
Habit-tic nail deformity, onychophagia (also referred to as nail biting) and onychotillomania (also referred to as nail picking) are body-focused repetitive behaviors that can involve the nails and periungual skin. Patients with habit-tic nail deformity are typically unaware that repeatedly using their nail, often the adjacent index finger, to rub the proximal nail fold and its underlying matrix - usually of one or both of their thumbnails - is the cause of the longitudinal depressed groove that extends along the entire the nail plate. Nail biters usually bite multiple nails - most commonly on the digits of the hands - and the patient is cognizant of their behavior. However, the term onychophagia is a misnomer and onychodaxia would be a more appropriate nomenclature. Nail pickers also often realize that their dystrophic nail results from using other nails or tools to pick, pull, or excessively manicure the affected nail. Individuals with habit-tic nail deformity or onychophagia or onychotillomania may concurrently have other repetitive behaviors involving the skin or the hair or both. Three patients with a nail-associated body-focused repetitive behavior are described who not only presented with dystrophy of their nails but also abnormalities of the adjacent nail apparatus: a 36-year-old woman with habit-tic nail deformity and dermatodaxia, a 64-year-old man with biting of both the nails and the skin, and a 63-year-old man with nail picking and skin picking. The nail dystrophy and concurrent skin biting or skin picking were not the issues that prompted the reported patients to seek evaluation by a physician; the body-focused repetitive behaviors of the nails and skin were incidental findings during their cutaneous examination. The management of nail-associated body-focused repetitive behavior may include non-pharmacologic treatments (such as physical modalities and behavior modifications) and/or pharmacologic agents. The reported woman with habit-tic nail deformity was willing to consider an attempt to modify her repetitive behavior by using paper tape as a physical modality to cover the area on her thumbs that she would unconsciously rub. However, similar to the men in this report with onychophagia and onychotillomania, many of the patients with nail-focused repetitive behaviors do not want to initiate any interventions that might decrease or eliminate their nail condition.
... Positive family history is found in 36.8%-63% of cases. 4,5 No instrument has been validated to specifically measure nail biting. 6 Studies point out that onychophagia could be classified as a tic disorder rather than obsessivecompulsive disorder. ...
... 1,4,[8][9][10] A quarter of nail biters seek treatment, and treatment has a significant effect in reducing symptoms of onychophagia. 5 On the other hand, 26.4% of parents do not seek treatment for onychophagia in children, and 70.2% think that punishment is an effective way to break a habit. 11 Onychophagia could serve as an informative clinical symptom for doctors working in different fields, especially mental health. ...
... The data found in the literature are mixed. Some studies indicate that there is no significant difference between the genders 5,11,23 ; others show that women bite their nails more often than men. 3,6 More than half of all doctors have heard complaints about nail biting from patients. ...
Although onychophagia is a medical condition and is associated with poorer health, there are no guidelines for assessment or treatment. The purpose of this study was to investigate the clinical aspects of nail biting from doctors’ points of view, to estimate the prevalence of onychophagia among physicians, and to review the literature on and treatment methods for onychophagia. Twenty-four percent of doctors reported nail-biting periods during their lifetimes, and 2% of them remained active nail biters. A total of 64.4% of doctors see nail biting in their practices, and 60.6% never or only on request ask patients about nail biting and examine their nails. Family doctors and pediatricians ask their patients about nail biting most often. Attitudes and opinions on the treatment of nail biting are undefined and vary. Doctors reported usually treating nail-biting patients by referring them to another specialist or offering special nail polish. There is a need to improve physicians’ knowledge of nail-biting treatment methods, but a lack of studies evaluating the clinical aspects of onychophagia and its relation to mental health and emotion dysregulation. Further research is needed. Clinical attitudes toward nail biting could be more precise in training and medical practice.
... Most studies of onychophagia have been conducted on children (9)(10)(11). There are limited data related to the prevalence of onychophagia in adolescents and young adults, and its relation to stress and quality of life. ...
... In this study, a questionnaire consisting of four sections was prepared with the guidance of literature (3,5,9). The first part of the questionnaire consisted of items about students' sociodemographics, the second part included items about onychophagia characteristics, the third part consisted of items on the Perceived Stress Scale (PSS), and the fourth part consisted of questions from the European Health Impact Scale (EUROHISQOL-8). ...
... Ghanizadeh et al. found that 22.3% of 7-to 10-year-old children had onychophagia in Iran (11). In the United States, the prevalence of nail-biting was found to be 37% in people 3 to 21 years old in an urban setting (9). In a study from Poland, the frequency of onychophagia among university students (21-26 years old) was found to be as high as 46.9% (16). ...
Introduction:
Onychophagia is defined as putting one's fingers into the mouth and biting the nails. We sought to evaluate the prevalence of onychophagia in university and high school students and its relation to sociodemographic factors, perceived stress, and quality of life.
Methods:
A total of 3,475 students were included in the study. A questionnaire including sociodemographic characteristics, items about onychophagia, the Perceived Stress Scale (PSS), and the European Health Impact Scale were used.
Results:
The prevalence of onychophagia among university students was 17.6%, and among high school students it was 29.2%. In university students with onychophagia, the median score on the PSS was higher than the median score of students without onychophagia. In high school students, the median score on the PSS was 28.2 for students without onychophagia and 28.0 for students with onychophagia; the difference was not significant. The median scores on the quality of life scale for both university and high school students with onychophagia were lower than the mean score of students without onychophagia.
Conclusions:
Onychophagia is a common problem in the general population with a multidimensional etiology. It has dermatological, dental, and psychiatric consequences and comorbidities, and so a multidisciplinary approach is necessary for the prevention and treatment of onychophagia.
... doi: https://doi.org/10.25208/vdv16798 Актуальность Онихофагия -хроническое заболевание, характеризующееся повторяющейся травматизацией ногтевых пластин пальцев кистей и стоп путем помещения их в рот с дальнейшим обкусыванием и жеванием [1][2][3][4]. Несмотря на то что к описанию данного расстройства предлагались и другие термины, например «ониходаксия» (от греч. daxiaкусать) [5], именно термин «онихофагия» является устоявшимся, общепризнанным определением в медицинском сообществе. ...
... Считается, что онихофагия является гетерогенным заболеванием, в развитии которого играют роль как генетические, так и факторы окружающей среды. В ряде исследований отмечен четкий семейный анамнез по онихофагии, что касалось как братьев, сестер, так и родителей пациентов [4,10]. Также в исследовании S. Ooki показано, что привычка грызть ногти была генетически связана и присутствовала у 50% пар близнецов [11]. ...
Onychophagia is a psychiatric disorder manifested by compulsive, repetitive biting of nail plates. To date, the etiopathogenesis of the disease remains incompletely understood. The leading role in the development of this condition is attributed to concomitant mental disorders. Nevertheless, onychophagy today is a complex interdisciplinary problem that requires the involvement of doctors of various specialties. Dermatologists are no exception. Clinical evaluation of nails in onychophagia by a dermatologist is important both in terms of diagnosis and possible ways of correcting pathologic changes in nail plates. This article provides up-to-date information on onychophagia with an emphasis on the dermatologic aspect of the disorder.
... 9,10 Nail biting is more common among youngsters, with a study reporting a 37% prevalence among individuals aged 3 to 21 years. 11 A recent study in Pakistan found that 39.2% of the children aged 4 to 10 years bit their nails. 12 This study further found that the mental problems are commonly present among children who bite their nail. ...
... 20 Other studies have linked aggression to the nail biting. 3,11,24 These and other studies have found that children who bite their nails are stressed, lonely, and lack affection, and that this behaviour may be indicative of underlying psychopathology. 18 Nonetheless, the link between mental health issues and nail biting has remained controversial. ...
Background: Onychophagia, commonly known as nail biting, is considered a compulsive behavioral disorder primarily observed in children and adolescents. Nail biting behavior leads to an increased presence of various opportunistic microorganisms in the oral cavity. This study aimed to investigate the association between nail biting and mental health in children aged 10 to 16 years. It further compares the load of Enterobacteriaceae in nail-biters and non-nail biters. Methods: A case control study was conducted on 50 nail biters (cases) and 50 non-nail biters (controls). Data were collected by using convenient sampling technique from school going students aged 10 to 16 years, using pre-designed and self-administered questionnaires, the Massachusetts General Hospital-Nail Biting Questionnaire (MGH-NBQ) and the Strengths and Difficulties Questionnaire (SDQ) as well as saliva samples taken and tested for bacterial growth. All ethical issues were taken into consideration. SPSS v23 was used to analyze the data using descriptive statistics to calculate the mean and standard deviation. The independent t test was used to compare mean SDQ scores between nail biters and non-nail biters. P-values<0.05 were considered statistically significant. Results: Among the 50 cases, 44 (88.0%) of the students had positive Enterobacteriaceae growth, while 13 (26.0%) of the controls did not. Nail biters had considerably higher mean scores for emotional symptoms, conduct problems, hyperactivity, and peer problems than non-nail biters (P value<0.001). All of the SDQ domains and nail biting were found to have a statistically significant (P=0.05) association. Conclusion: The study highlights the persistent and burdensome nature of nail biting, which poses risks in terms of disease transmission. Additionally, nail biting has been associated with various behavioural and emotional disorders. Awareness of the harmful consequences of nail biting, along with appropriate preventive and treatment approaches, can assist young individuals in discontinuing this habit.
... Muchos de estos hábitos pueden causar fatiga y rigidez muscular, síntomas que son considerados desencadenantes de trastornos de la articulación temporomandibular en la población infantil, al momento de hacer el diagnóstico. (21) La presencia de hábitos orales no fisiológicos en pacientes con algún tipo de maloclusión, oscila entre el 47% y el 96% según reportes en diferentes investigaciones (1,3,9,12,22), rango en el que se encuentra el valor estimado en el presente estudio. ...
... (3,17,25) Este hábito está asociado a un cambio social y psicológico, además, es de suma importancia evaluarlo al momento del examen clínico pues es uno de los más difíciles de erradicar. (10,12) Aunque los hábitos como la succión digital y labial fueron encontrados en un menor porcentaje en esta investigación, es importante resaltar que, de acuerdo con estudios previos, la succión digital presenta una relación directa con la presencia de mordida cruzada posterior y la mordida abierta anterior. (17,25) Sin embargo, en el presente estudio no se obtuvo una significancia estadística, posiblemente relacionado con la diferencia del tamaño de muestra con los estudios anteriormente mencionados. ...
Introducción: Durante la etapa de crecimiento y desarrollo los hábitos orales de los niños pueden ser causa la presencia de maloclusiones, según la frecuencia, duración e intensidad y tipo de habito. En este contexto, el objetivo de este estudio fue describir la presencia de hábitos orales no fisiológicos y evaluar su relación con los diferentes tipos de maloclusión. Métodos: Estudio descriptivo de corte transversal, se incluyeron 77 niños entre los 4 y 14 años, de 2018 a 2019. Se realizó un análisis univariado reportando frecuencia y un análisis bivariado para evaluar independencia de las variables aplicando la prueba de Chi2 Pearson. Resultados: La distribución según el tipo de dentición fue temporal 20,8%, mixta 71,4% y permanente 7,8%. La presencia de hábitos predominó en mujeres. La interposición lingual fue el hábito más frecuente en pacientes con los tres tipos de maloclusión; Seguido del rechinamiento nocturno para pacientes con maloclusión clase I; en pacientes clase II/1 y III la onicofagia. Aquellos con mordida profunda presentaron rechinamiento nocturno en un 16% y los de mordida abierta interposición lingual en un 54,4%. Conclusiones: Se encontró mayor frecuencia de hábitos orales no fisiológicos en pacientes en dentición mixta. No hubo relación estadística entre los hábitos orales y la presencia de maloclusión.
... The prevalence of habitual nail biting is about 37% in pediatric population. Approximately, 36% of nail biting occurs in school children under the age of 5 years, 57% in 12 year age and 36% of adolescence until 16yrs in New York, USA (Winebrake et al., 2018). A study was conducted in Republic of Korea illustrated that NB occurs in children between ages 7 and 10 years. ...
... En una encuesta reciente realizada en una práctica pediátrica ambulatoria, la prevalencia de onicofagia entre los participantes en el mes anterior alcanzó el 37%, con una edad media de inicio a los 5 años. Los pacientes con antecedentes de onicofagia tenían tres veces más probabilidades que los no morderse las uñas de informar un historial de un trastorno psiquiátrico concomitante(Winebrake, 2018).El tratamiento de la onicofagia puede ser multimodal, incluyendo terapia de aversión con aplicaciones tópicas (como lacas amargas para las uñas), terapia psicológica (control de estímulos y entrenamiento en reversión de hábitos) y farmacoterapia oral (N-acetilcisteína 1200-2400 mg/día). La colaboración con proveedores de salud mental pediátrica ha demostrado ser útil en la implementación de estas terapias cognitivo-conductuales(Magid, 2017).La onicofagia generalmente se desarrolla en la infancia, después de los 3 a 4 años de edad.Datos de Estados Unidos indican que la prevalencia en niños en edad preescolar se informó en 23%, aumentando y alcanzando un pico en la adolescencia, para luego disminuir a medidaRevista Social Fronteriza ISSN: 2806-5913 | doi: 10.59814/resofro.2024e337 ...
La onicofagia, que afecta al 20-30% de la población en diversos grupos etarios, se asocia frecuentemente con problemas psicosociales y de salud oral. Este artículo revisa la prevalencia, etiología, historia, complicaciones y manejo de la onicofagia, con un enfoque particular en su relación con la ansiedad. Se realizó la revisión sistemática de la literatura en PubMed utilizando términos MeSH como "nail biting," "onychophagia," y "anxiety," revela que la onicofagia está asociada con altos niveles de ansiedad, aunque las evidencias no siempre muestran una relación directa y consistente. Estudios recientes indican como resultado que el hábito de morderse las uñas está relacionado con un aumento en los síntomas de ansiedad y problemas en las articulaciones temporomandibulares. La presencia de onicofagia puede implicar un mayor riesgo de trastornos psicológicos y físicos, siendo fundamental la intervención multidisciplinaria para su manejo. Conclusivamente, aunque la onicofagia y la ansiedad están correlacionadas, se necesita más investigación para entender completamente esta relación y desarrollar estrategias de tratamiento efectivas.
... Patients seldom appear with nail biting or nail picking as the primary symptom, thus a correct diagnosis requires a thorough history and physical examination. Dermatologists, internal medicine doctors, pediatricians, psychiatrists, and dentists all have a role in the care of onychophagia and onychotillomania [6][7][8][9][10]. ...
Background:In the fields of psychiatry, psychology, medicine, and dentistry, nail biting (NB) is a prevalent yet unsolved issue. Although many people assume that NB is a basic habit that can be readily corrected, many children who exhibit NB have previously attempted to correct the behavior and have failed.The aim of the present research focused on the reason for onychophagia or nail-biting if it is a psychological disease or a general habit and recommend some suitable suggestions. Methods:An inductive research approach was suitable for the present research methodology as it involved a survey process. The research approach helped in collecting information in an effective way. A stratified random sampling method was considered for the present research method through the inclusion of participants that are suffering from the issue of nail-biting belonging to the UK. The sample size for the research methodology included a total of 350 participants belonging to the age groups of 18 to 50 years. The primary data collection method was considered for the present research methodology as it followed the cross-sectional method. The quantitative data analysis method would be considered under the primary research method and so a survey would be done. Results: Of 380 study participants,more than half of them believe that nail biting is a psychological disorder (n= 219, 58.1%). Furthermore, about two thirds of study participants believe that nail biting is a common disorder among humans (n= 247, 65%). Most of study participants think that nail biting is curable (n= 296, 77.9%). Daily exercise is helping in reducing the habit of nail biting as reported by 178 (73.2%). Half of study participants were neutral with regard to the benefit of psychological treatment to nail biting (n= 184, 48.4%). Vast majority of study participants believed that exercise is effective for enhancing mental stability (n= 318, 83.7%).Leading a life with a the disorder or nail biting issue was moderately painful among 165 participants (43.3%). Participants were asked about the cost of medication for onychophagia, most of participants responded with affordable cost (n= 270, 71.1%). The most frequent symptom of nail biting issue as reported by study participants was moderate span of time (n= 234, 61.6%). Conclusion: Onychophagia is a psychological disorder from the perspective of study participants. Furthermore, they recommended medical treatment and stated that psychological treatment alone is not enough. Moreover, exercise helps with mental stability as reported by study participants.
... Familial, psychiatric and behavioural factors are reported to be associated with paediatric nail biting, with an onset around 5 years of age. 21 A closer inspection of children's behaviour should be considered when the nail biting habit appears around the beginning of school age, as it may be confused with anxiety associated with a new learning environment. ...
Objective
To evaluate the prevalence of nail biting in child and adolescent outpatients at a single institution and the chronological relationship between nail biting and tics in patients with Tourette syndrome (TS) with or without attention-deficit hyperactivity disorder (ADHD).
Design
Retrospective observational study.
Setting
Teaching hospital in Taiwan.
Participants
All participants were aged 4–18 years, including 535 patients with TS, 230 patients with provisional tic disorder and 1460 patients without neurological or psychiatric disorders (controls).
Outcome measures
Presence of nail biting, starting age for nail biting and starting age for motor and/or vocal tics.
Results
Nail biting was more commonly observed in patients with TS (56.6%) than in patients with provisional tic disorder (27.4%) or controls (15.0%), regardless of sex (all p<0.020). Nail biting was also more common in patients with TS with ADHD than in those without (75.0% vs 47.6%; p<0.001), but the starting age was significantly later in those with concomitant ADHD than without (5.3 vs 3.8 years; p<0.001). In patients with TS, the onset of nail biting occurred earlier than that of tics, regardless of ADHD status.
Conclusion
Nail biting was more prevalent and occurred earlier than tics in patients with TS, regardless of ADHD status, in the study population.
... yer aldığı belirtilmiştir (Winebrake ve ark. 2018). BOTD için tanımlanmış risk etmenlerinin ileri yaş; kadın cinsiyet; ailede BOTD, OKB, Alkol/Madde Kullanım Bozukluğu öyküsü; birbirine daha az bağlı ve duygu dışavurumu zayıf aile yapısı; travmatik yaşam olayları; dürtüsellik; yüksek nörotisizm ve düşük dışadönüklük ile ilişkili kişilik özellikleri olduğu görülmektedir (Grant ve ark. 20 ...
Objective:
Body Focused Repetitive Behaviors (BFRB) is an umbrella term for undesirable, repetitive motor activities such as Trichotillomania (TTM), Skin Picking Disorder (SPD), nail biting, cheek chewing, lip biting, finger sucking, finger cracking and teeth grinding. Such behaviors are engaged in to eliminate a part of the body and may result in impaired functionality. The frequency of presentation to clinicians is low since BFRB are defined as harmless, although the number of studies on this condition has increased rapidly recently, including those making a clear determination of epidemiological data, those investigating the etiopathogenesis and those providing treatment guidelines, although they remain inadequate. The present study provides a review of studies investigating the etiology of BFRB to date.
Method:
Articles published between 1992 and 2021 stored in the Pubmed, Medline, Scopus and Web of Science databases were reviewed, and the prominent research studies of the condition identified were included in the evaluation.
Results:
Studies investigating the etiopathogenesis of BFRB were found in most cases to investigate adult populations, and were hampered by such confounding factors as clinical heterogeneity, high rates of comorbid psychiatric diseases and small sample sizes. The identified studies reveal that attempts have been made to explain BFRB based on behavioral models, and that the condition is inherited at a high rate. Treatment planning is mostly associated with monoamine systems (especially glutamate and dopamine) and interventions were directed to addiction elements. Furthermore, cognitive flexibility and motor inhibition defects in neurocognitive area and cortico-striato-thalamocortical cycle abnormalities in neuroimaging studies have been reported.
Conclusion:
Studies investigating the clinical features, incidence, etiopathogenesis and treatment of BFRB, which holds a controversial place in psychiatric classification systems, would contribute to a better understanding of the disease and a more appropriate definition of the condition.
... Onychophagia and onychotillomania sometimes are associated with psychiatric disorders (Winebrake, Grover, Halteh, & Lipner, 2018;Solley & Turner, 2018;Gupta, 2019). The presence of self-destructive behavior in one family may indicate genetic predisposition (Bakwin, 1971). ...
Onychophagia and onychotillomania are rarely seen in clinical practice and are considered undervalued. The study aims were to determine the prevalence of onychophagia and onychotillomania habit in the patient group with hand nail damage and control group, to determine which would be the target population to educate. Patients were interviewed about self-destructive habits. Excel and SPSS were used for data analysis. In the nail damage group, 28.6% of the respondents showed self-destructive habits and past habits – 31.4%. In the control group, the result was 22.9% and 31.4%. For 74.3% of patients the cause of nail damage was skin disease (including 61.54% of respondents with nail damage who have psoriasis), for 5.7% it was age-related nail changes, for 20% traumatic damage and for 57.14% of them it was a result of self-destructive habit. In the nail damage group both – present and past self-destructive habits are higher than in the control group, but it has no statistical significance (p=0.785). 1)The prevalence of onychophagia and onychotillomania does not differ between patients and control group. 2)General education of the population is necessary to actualize this problem, which can worsen nail changes.
... There is limited data on prevalence of BFRBs. Estimated prevalence of skin picking is 1-5%, trichotillomania is 0.5-2%, onychotillomania is 1%, and onychophagia is 20-30% of the United States population [6][7][8][9]. However, our findings indicate that, at least in this study population, skin picking, trichotillomania, and nail picking may be more common than previously reported since the proportion of commenters with one of these three conditions and nail biter commenters was similar. ...
In September 2019, the New York Times (NYT) published the article “Fighting the Shame of Skin Picking,” which discussed the cosmetic, social and emotional impacts of body-focused repetitive behaviors (BFRBs). BFRBs, including excoriation disorder, trichotillomania, onychotillomania, and onychophagia, are recurring actions that damage one’s physical appearance. The aim of this study is to characterize the demographic information provided and themes raised in the 166 comments posted in response to the article. The most commonly reported condition was skin picking (38.2%), followed by trichotillomania and/or trichophagia (30.3%), onychotillomania (24.7%), and onychophagia (23.6%). All conditions had a female predominance. Treatment of body-focused repetitive behaviors was the most common topic of discussion, followed by shame and impact on appearance. Since commenters described significant impairments to quality of life, larger randomized controlled trials on skin picking, trichotillomania, onychophagia, and onychotillomania are necessary to provide evidence-based management to patients.
Onychophagia describes chronic, habitual nail biting [1] and is classified as a body-focused repetitive behavior (BFRB) [2]. Biting may involve the nail plate, nail bed, nail matrix, and periungual skin [3] with varying clinical presentations dictated by the extent and severity of biting [4]. It is estimated that onychophagia affects between 20% and 30% of the general population [4–10]. Due to its association with psychiatric comorbidities, negative social implications, and embarrassment, onychophagia is often underrecognized in clinical practice, which may impact prevalence estimates [4, 11].
Nail is a hard cutaneous structure; however, it is susceptible to external and self-induced injury that can lead to alterations in morphology. Self-induced nail disorders are a group of varied clinical manifestations that are caused by the patient voluntarily. They are classified as body-focused repetitive behaviour disorders (BFRBs). Common habits that lead to nail changes but are not associated with overt psychological abnormalities include onycholysis semilunaris, habit tic and onychophagia. The other major class includes nail disorders associated with psychiatric diseases, for example, onychodaknomania. These disorders often mimic a variety of nail conditions. Patients may not present to clinicians with these disorders as the primary complaint. An underlying psychiatric or psychological condition is often found, especially in adults. Hence, clinicians need to be aware of this clinical entity to be able to offer correct diagnosis and appropriate management. Multidisciplinary management is suggested, involving both non-pharmacological and pharmacological approaches. Behavioural interventions such as habit reversal therapy have a role in management. This article is aimed at analysing and presenting literature about these nail disorders to raise awareness. It discusses in detail various clinical entities, pathomechanisms, associated disorders and management.
Diseases of the nail unit may have numerous causes that reflect dermatology as a whole but often present in a unique way. This chapter attempts to increase insight into the pathophysiology of the expression of nail abnormalities. It also focuses on many groups of nail disease, including traumatic nail disorders, tumours of and around the nail unit, perionychial disorders, age‐related nail abnormalities, and frequent dermatoses affecting the nails, such as nail psoriasis, eczema and lichen planus. Imaging of the nail, nail surgery and some cosmetic aspects of nail care are also discussed.
Introduction: Nail biting is an inappropriate habit and its exact cause is debatable. Researchers believe that nail biting disorder is often associated with psychiatric disorders, including anxiety. State/trait anxiety can be considered an unstable emotional state reflecting the individual's interpretation of a stressful situation in a particular time frame and varies depending on the degree to which the situation is perceived threatening. This study aims to determine the evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety in students. Methods: The present semi-experimental study with pretest, post-test, and follow-up was conducted on six junior high school male students in the age range of 13-15 years, who asked for help by referring to the school counseling and were selected by convenience sampling method. They received a program of habit reversal techniques individually in 6 sessions for 1 month. Clinical interviewing, frequency recording of nail biting per day, and state/trait anxiety test were used to measure the variables. Results: Data analysis showed that habit reversal techniques reduce nail biting and students' state/trait anxiety. Follow-up one month after the end of treatment indicated the persistence of these results. Conclusion: The habit reversal training is effective on treating nail biting, reducing anxiety, and promoting the person life quality and symptoms from nail biting. Due the low sample size, it is suggested that while repeating the study in a larger sample, its effectiveness on the treatment of other habitual disorders be studied.
Purpose
Onychophagia, or habitual nail biting, is a common disorder, especially in children and young adults. Multiple factors contribute to its development, from emotional triggers to genetics and underlying psychiatric conditions. Nail biting can have a significant impact on one’s quality of life, and its complications are not limited to cosmetic distortion. In severe cases, uncontrolled onychophagia can cause serious physical, dental, and psychosocial consequences. In this article, we review the use of N-acetyl cysteine (NAC), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), lithium, and silymarin as possible treatment modalities for chronic nail biting.
Recent Findings
There are many established behavioral and psychological interventions for the treatment of onychophagia, albeit modest in efficacy. And up until today, there is minimal evidence that supports effective pharmacotherapy. However, several of these drugs show promising results that warrant further exploration.
Summary
NAC was found to be more effective than placebo in the short term, while SSRIs showed contradictory results. TCAs (especially clomipramine), lithium, and silymarin have also exhibited potential in curbing nail biting behavior to different extents. Further studies are required to outline a definite treatment modality for onychophagia, along with corresponding therapeutic doses.
Pediatric psychodermatologic conditions encompass both primary dermatologic conditions with psychiatric comorbidities and primary psychiatric conditions with self-induced dermatologic manifestations. Detection, diagnosis, and management of primary psychiatric conditions with dermatologic manifestations are challenging due to patient-perceived stigma and lack of educational opportunities for dermatology providers. This two-part series highlights the most up-to-date evidence-based data and management techniques of some of the more common dermatoses of primary psychiatric conditions in children. Part I includes trichotillomania, skin-picking disorder, and onychophagia, and part II covers dermatitis artefacta, body dysmorphic disorder, and delusions of parasitosis by proxy, with special considerations for family dynamics.
Background
Onychophagia is a common disorder affecting 20% to 30% of the general population. It is defined as habitual nail biting and can cause various changes in the nail units. However, to date, there has been a paucity of data focusing on nail deformities related to onychophagia. This study was performed to investigate the clinical characteristics of onychophagia in Korea.
Methods
This study included 53 patients with onychophagia who visited the Pusan National University Hospital (Busan and Yangsan) over a 10-year period (2011–2020). We retrospectively reviewed medical records and clinical and dermoscopic photographs.
Results
All 10 fingernails were affected in 37.7% of the patients. The left thumbnail was the most predominantly affected site (81.1%). Clinical findings showed that short nails with ragged distal borders were the most common presentation (100.0%), followed by generalized or patchy rough areas (50.9%), linear and pinpoint hemorrhage (32.1%), longitudinal melanonychia (30.2%), transverse groove (28.3%), brittleness (28.3%), macrolunula (24.5%), washboard nail (13.2%), and pterygium (3.8%). Of the patients, 88.7% had periungual complications, such as periungual exfoliation (77.4%), absent or ragged cuticle (52.8%), hyponychial hyperkeratosis (37.7%), and paronychia (15.1%).
Conclusions
Although onychophagia is a common disorder, its clinical characteristics have not been reported in the literature. The results of this study may be helpful in managing patients with onychophagia.
Objetivo. Evaluar la frecuencia de hábitos orales parafuncionales y su relación con dos grupos etarios. Material y Métodos: Se llevó a cabo un estudio transversal en una muestra de 269 preescolares, bajo autorización expresa de sus padres. La encuesta epidemiológica estuvo conformada por el examen bucal y la aplicación de un cuestionario (alfa de Cronbach=0,832), previa estandarización de una Cirujana Dentista (Kappa=0,941). Para medir la fiabilidad del cuestionario se calculó el valor del alfa de Cronbach y para las asociaciones la Chi cuadrada de Mantel y Haenszel para tablas de contingencia tetrateóricas. Resultados. El hábito de morder objetos fue el hábito más frecuente (31.2%), la onicofagia y la queilofagia mostraron diferencias estadísticamente significativas en relación con el grupo de preescolares (X2MH= 7.267, p=0.007; X2MH=4.046, p=0.044), mientras que el uso de biberón lo fue para el grupo maternal (X2MH=13.825, p=0.0001). Por sexo no se encontraron diferencias relevantes entre niños y niñas. Conclusiones. Se evidenciaron algunas diferencias en cuanto al comportamiento de los casos de este tipo de hábitos sin que el sexo resultara ser un factor relevante en la presencia de algún tipo de hábito parafuncional.
Most pediatric nail conditions are benign but remain a source of anxiety for parents or physicians inexperienced in onychology and may be a cosmetic issue or a cause of functional impairment. This review includes the most relevant articles from the last 5 years. Physiologic alterations at birth are frequent and important to recognize. Nails are involved in many congenital disorders and part of a larger clinical spectrum of many genetic syndromes. Among infectious diseases, periungual warts are very challenging to treat. On the contrary, onychomycosis seems easier to treat in children than in adults. As in adults, nail psoriasis is associated with a higher risk of psoriatic arthritis and metabolic comorbidities. Crushing injury of finger by a door is the most common cause of acute nail trauma. The management of subungual hematomas and nail bed laceration still remains controversial. Podiatric abnormalities are underestimated and should be considered as a potential cause of nail dystrophy in children. Children who suck their thumbs or bite their nails are less likely to have atopic sensitization. Topical steroids should be the first-line treatment for retronychia and surgery only restricted to nonresponsive cases. Longitudinal melanonychia in children displays more worrisome melanoma-associated features than in adults, but the very vast majority are benign, and a wait-and-see policy is the gold standard. Yellow nail syndrome is extremely rare in children but should raise the potential role of titanium in candies and toothpastes.
Onychophagia, commonly referred to as nailbiting is a chronic condition that is repetitive and compulsive in nature, and generally seen in both children and young adults. Multiple factors play a role in the development of nailbiting, ranging from genetic components, to underlying psychiatric conditions. Complications of chronic, compulsive nail-biting range from obvious distortion of the nail bed unit, to ungual and oral infection. Dental hygiene is, typically, less well-maintained in patients with nail-biting disorders: teeth may become chipped or notched, and gums many become inflamed. Treatment of nailbiting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. Treatment ranges from psychotherapy modalities, to medication trials of selective serotonin reuptake inhibitors and N-acetylcysteine. Proper nail hygiene remains a mainstay in the prevention of the complications of chronic nail-biting. Additional supportive measures include the support of self-motivational novels and television episodes that help children learn coping mechanisms.
Purpose of review:
Nail disorders represent an uncommon subset of complaints seen in pediatric dermatology. There is a wide array of disorders that can affect the nail unit in children, including infectious, inflammatory, neoplastic, congenital, and traumatic processes. In order to enhance familiarity with pediatric nail conditions, we review the background and treatment of the more common entities seen in pediatric onychology, including onychomycosis, onychomadesis, nail psoriasis, trachyonychia, longitudinal melanonychia, onychophagia, and onychocryptosis.
Recent findings:
Nail involvement in pediatric patients with psoriasis may indicate increased risk for both overall disease severity and the development psoriatic arthritis. In the evaluation of longitudinal melanonychia, the clinical findings that raise concern for subungual melanoma in adults are often found in benign nail unit nevi in children. In the systemic treatment of pediatric onychomycosis, new data raises the possibility that laboratory monitoring may be approached differently. In the approach to onychophagia, emerging pharmacotherapies include N-acetylcysteine.
Summary:
Most nail disorders in pediatric patients have an overall favorable prognosis. However, nail abnormalities can lead to patient and parental anxiety, decreased quality of life, pain, and functional impairment. Clinicians should be aware of these more common diverse entities in order to identify them and apply state of the art management for these issues. Additionally, the reader will learn factors related to these nail disorders, which may require systemic work-up and/or specialist referral.
A boy with multiple phonic tics, one lifetime motor tic, and no impairment or marked distress does not meet criteria for any DSM-5 tic disorder diagnosis. The next version of the Diagnostic and Statistical Manual should adjust the criteria for Tourette's Disorder and/or for "other specified tic disorder" and "unspecified tic disorder."
The association between Tourette Syndrome (TS) and body-focused repetitive behaviors (BFRBs), including skin picking disorder (SPD), hair pulling disorder (HPD) and pathological nail biting (PNB) is rarely studied, especially in TS pediatric samples, even though TS and BFRBs share many characteristics. This study therefore sought to determine the prevalence rates and predictors of SPD, HPD and PNB in a pediatric TS sample. Data from 739 child and adolescent participants who completed validated instruments to assess for tic severity and various other comorbidities were used to calculate prevalence rates for each of the BFRBs. Clinical and demographic predictors were determined via regression modelling. The prevalence rates for SPD, HPD and PNB were 5.8%, 2.4% and 6.0%, respectively. The presence of PNB and worst ever tic severity predicted the presence of SPD. Worst ever tic severity and the presence of SPD were the only significant predictors of HPD and PNB, respectively. When distress was dropped as a diagnostic requirement for the BFRBs, the prevalence for SPD, HPD and PNB increased to 18.4%, 7.6% and 11.8%, respectively, while the predictors were generally the same. The prevalence rates for SPD, HPD and PNB were similar to estimated rates in the general population. However, their association with tic severity suggests a relationship between BFRBs and TS. These findings suggest that more research is needed to further elucidate the nature of the relationship between TS and BFRBs, especially in pediatric populations.
Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.
Introduction:
Dental and maxillofacial anomalies have multiple and complex causes. Most frequent among these are poor oral habits. A large number of children present with oral malocclusions, most of which are caused by deforming oral habits. It is important to learn about risk factors for this condition in order to institute preventive measures, early detection and treatment, and identification of low- and high-risk groups.
Objectives:
To identify risk factors associated with deforming oral habits, which, if maintained over time, are responsible for occlusion defects, speech disorders, and can affect physical and emotional child development.
Methods:
A case-control study of children presenting with deforming oral habits in the municipality of Manzanillo in Granma province was conducted between January and August 2013. 540 children aged 5 to 11 were included of which 180 had deforming oral habits and were asked to fill out a survey to identify specific type of habits leading to malocclusion. The case group was composed of children with deforming habits, and the remaining 360 children without poor oral habits were the control group. Each case was randomly matched to two control cases. The children mothers were also surveyed to gather supplemental information.
Results:
Children with deforming oral habits were mostly female. At age 10, onychophagia was the predominant oral deforming habit. Risk factors detected for these habits were sociobiological maternal and child variables such as low and high birth weight, maternal breastfeeding inexperience, and discord in the family.
Conclusions:
The study identified likely risk factors associated with deforming oral habits. These are discord in the family, birth weight, and lack of breastfeeding experience.
Onychophagia is defined as chronic nail biting behaviour, which usually starts during childhood. Onychotillomania results from recurrent picking and manicuring of the fingernails and/or toenails, leading to visual shortening and/or estraction of nails. The aim of this study was to assess the prevalence of onychophagia and onychotillomania in young adults, and the comorbidity of these conditions with anxiety disorders and obsessive compulsive disorders (OCD), as well as to determine factors related to these behaviours. A total of 339 individuals were interviewed with a structured questionnaire. Onychophagia was present in 46.9% of participants (including 19.2% active and 27.7% past nail biters), and an additional 3 people (0.9%) had onychotillomania. The majority of subjects (92.2%) described nail biting as an automatic behaviour. Tension before nail biting was reported by 65.7% of nail biters, and feelings of pleasure after nail biting by 42%. Among the participants with lifetime onychophagia, 22.5% met criteria of anxiety disorder and 3.1% of OCD, while in the group without onychophagia at least one anxiety disorder was diagnosed in 26.2% and OCD in 5.0%. We did not find any correlation between nail biting and other anxiety disorders or OCD. In conclusion, no single condition was associated with nail biting or influenced such behaviour; multiple psychological factors were involved.
This study evaluates onychophagia or nail biting (NB) prevalence and association with mental health of a community sample of children from Shiraz, Iran.
The parents of 743 primary school children, selected by random sampling, reported NB behavior of their children and themselves. Children's mental health problem was assessed using the Strengths and Difficulties Questionnaire (SDQ). 22.3% (95% CI: 19.3 to 25.3) of children had NB behavior in the last three months (girls: 20.1% (95% CI: 15.9 to 24.2). The rate in boys was 24.4% (95% CI: 20.1 to 28.7). 36.8% of the children with NB had at least one family member with nail biting. Older age was associated with a higher prevalence of NB while a higher score on the prosocial score was associated with a lower prevalence of NB.
NB is a very common behavior in both genders in children and their family members. Children with NB have less prosocial ability than those without it.
Objective: To compare parental psychopathology and psychiatric disorders in ADHD children with and those without enuresis. Method: The participants of the clinical sample interviewed according to DSM-IV diagnostic criteria were 35 children with ADHD and enuresis, 153 ADHD children without enuresis, 115 fathers, and 172 mothers. Results: Only ODD comorbidity was the predictor of enuresis. Conduct disorder, tic disorder, major depressive disorder, separation anxiety disorder, bruxism, generalized anxiety disorder, obsessive compulsive disorder, and nail biting were not statistically more frequent in ADHD children with enuresis than in the ADHD children without enuresis. The only parental psychiatric disorder that was related to the groups was father’s major depressive disorder. Conclusion: Enuresis in ADHD has a relationship with ODD. Physicians who treat patients with ADHD and enuresis should routinely inquire about the presence of major depression in the fathers. (J. of Att. Dis. 2010; 13(5) 464-467)
To examine the frequency, age trends, and situational correlates of nervous habits (e.g., nail-biting, thumb-sucking) and motor stereotyped behaviors (e.g., body-rocking) in typically developing preschool children.
Data were compiled from 100 teacher interviews and 32 parent interviews on children aged 3 to 6 years. A semistructured, individually administered interview was used.
Parents reported the most behaviors, with the most common behaviors being thumb-sucking (25%) and nail-biting (23%). Motor stereotypies demonstrated a frequency of 4% as reported by the teachers and a frequency of 3% as reported by the parents. Teachers reported a decrease in children having the nervous habit of picking at sores, lips, etc., with age. Parents reported a significant decrease in all nervous habits with age. Nervous habits were associated with structured times during the day and negative mood states, and teachers reported that girls were more likely than boys to display nervous habits.
Nervous habits and stereotypies are prevalent in typically developing preschool children, and their presence appears to be a reflection of mood state.
Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by DSM-IV criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age of the children was 8.7, mothers, 40.1, and fathers, 34.6 years. Only 7.6% of the boys and 21.7% of the girls manifested ADHD without any other psychiatric comorbidity. The most common comorbid disorders were disruptive behavior disorders and anxiety disorders. The prevalence of lifetime ADHD in the parents was 45.8% and 17.7%, respectively. The rate for major depressive disorder in mothers and fathers was 48.1% and 43.0%, respectively. Discussion: The clinical sample of ADHD children typically had at least one other psychiatric disorder, usually oppositional defiant disorder in boys and anxiety disorders in girls. The most common psychiatric disorder in the parents was mood disorder. (J. of Att. Dis. 2008; 12(2) 149-155)
Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.
Onychophagia, defined as habitual nail biting, is a common disorder affecting 20-30% of the population and all age groups. It may lead to significant psychosocial problems, have a negative impact on quality of life, and cause complications involving both the nail unit and the oral cavity. The objective of this paper is to review the prevalence, etiology, history, physical examination, complications and management of nail biting. Since onychophagia is a challenging disorder to treat, a multi-disciplinary approach should be taken involving dermatologists, internists, pediatricians, psychiatrists and dentists.
A consecutive series of white naval recruits, consisting of 6946 men ranging in age from 17 through 37, was interrogated about and observed for the nail-biting mannerism. Of this group, tallies were kept for 4649 men in order to determine age-frequency characteristics. A group of 200 men were studied in more detail. One hundred of these were addicted to the habit. The following statements summarize the results that obtained.
1. Approximately 21.5 percent of the 6946 men were nail-biters.
2. The incidence-age curve for the nail-biting attribute reveals a secular trend when the data are viewed historically. A rapid increment in frequency from the age of 3 to the age of 15 (Wechsler data) exists. A gradual decrement from the age of i6 through 37 follows.
3. Evidence suggests that the application of the early Freudian theory of psychosexual development to these findings conceals more than it reveals.
4. A tentative, working hypothesis is suggested whereby the nail-biting mannerism is regarded as a tension-reducing mechanism acquired, for the most part, unconsciously.
5. The specific explanation for the habit rests upon the careful, clinical study of the individual personality. Only in this way can the dynamics of the mannerism be fully understood.
This study aimed to evaluate the associations between psychological factors and the presence of deleterious oral habits in children and adolescents.
147 students aged 8 to 14-years-old were divided in two groups concerning the presence and absence of DOH Habit group (HG) and Habit free group (HFG). Participants were asked about the presence of DOH using the domain III (Oral Habits) of the Nordic Orofacial Test-Screening (NOT-S). Symptoms of anxiety and depression were evaluated using the Brazilian Portuguese versions of the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI), respectively. Saliva was collected 30 min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). Data were analyzed using the Chi-squared, Mann-Whitney, Spearman's correlation and logistic regression.
The prevalence of DOH was higher in females than males (65.1 vs 34.9; p < 0.05). The most frequent DOH was nail biting (58.7%). HG presented more depressive symptoms than HFG (p < 0.05). There was positive correlation between salivary cortisol levels and age (p < 0.01). Logistic regression analysis found association between symptoms of anxiety and the presence of DOH (OR = 2.35; p < 0.05).
In conclusion, children and adolescents with DOH presented more symptoms of depression than their counterparts. Moreover, they were more likely to report symptoms of anxiety.
Background:
This study was taken to assess the prevalence of deleterious oral habits among 6-12 year old school going children.
Materials & methods:
A sample size of 832 children was finalized with simple random sampling technique including 444 males and 388 females. To get the demographic information and presence of harmful oral habits a closed-ended questionnaire was developed. Clinical evaluation was also done using mirror and water tests. Chi-square test was done to compare the prevalence of oral habits among different age groups and gender at p<0.05.
Results:
Bruxism (17.3%) was most commonly seen followed by bottle feeding (10.1%), thumb sucking (8.7%), nail biting (5.8%), tongue thrusting (4.9%) and mouth breathing (4.3%). Prevalence of all deleterious habits were more among female children and it also showed significant differences according to age.
Conclusion:
The data showed high prevalence of these oral habits. This highlighted the need for preventive orthodontic treatment at early age of life so that future occurrence of malocclusion can be avoided. How to cite the article: Garde JB, Suryavanshi RK, Jawale BA, Deshmukh V, Dadhe DP, Suryavanshi MK. An epidemiological study to know the prevalence of deleterious oral habits among 6 to 12 year old children. J Int Oral Health 2014;6(1):39-43.
Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
The familial relationship between obsessive-compulsive disorder (OCD) and "obsessive-compulsive spectrum" disorders is unclear. This study investigates the relationship of OCD to somatoform disorders (body dysmorphic disorder [BDD] and hypochondriasis), eating disorders (e.g., anorexia nervosa and bulimia nervosa), pathologic "grooming" conditions (e.g., nail biting, skin picking, trichotillomania), and other impulse control disorders (e.g., kleptomania, pathologic gambling, pyromania) using blinded family study methodology.
Eighty case and 73 control probands, as well as 343 case and 300 control first-degree relatives, were examined by psychiatrists or Ph.D. psychologists using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety version. Two experienced psychiatrists independently reviewed all diagnostic information and made final consensus diagnoses using DSM-IV criteria.
Body dysmorphic disorder, hypochondriasis, any eating disorder, and any grooming condition occurred more frequently in case probands. In addition, BDD, either somatoform disorder, and any grooming condition occurred more frequently in case relatives, whether or not case probands also had the same diagnosis.
These findings indicate that certain somatoform and pathologic grooming conditions are part of the familial OCD spectrum. Though other "spectrum" conditions may resemble OCD, they do not appear to be important parts of the familial spectrum.
This epidemiological study was conducted upon 4,590 school children to find the prevalence of oral habits in Mangalore in relation to their age and sex and to find the correlation, if any, between the habits and the malocclusion status. We noted that 29.7% of the population had habits of which 3. 1% had digit sucking, 4.6% mouth breathing, 3.02% tongue thrusting, 6.2% bruxism, 6% lip/cheek biting, 12.7% nail biting, 9.8% pencil biting and 0. 09% masochistic habits respectively. Digit sucking, pencil biting and tongue thrust were highly prevalent among Group 1 (3-6 years) children. Mouth breathing and bruxism were significant in Group 2 (7-12 years) cases whereas lip/cheek biting and nail biting were more common in Group 3 (13-16 years) cases. Digit sucking, tongue thrust, mouth breathing and bruxism were more prevalent among the boys whereas lip/cheek biting, nail biting and pencil biting were more prevalent among the girls. 28.95% of the children in Group 2 and 3 with habits had malocclusion. There was a significant correlation between class I type 2, class II div 1 and tongue thrust and mouth breathing whereas children with digit sucking showed a high correlation with class I type 2 malocclusion.