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Habitual Nail Biting, Psychiatric Disorders Linked

Am J Clin Dermatol; 2018 Dec; Winebrake, et al

Behavioral patterns, as well as familial, psychiatric, and other factors, are associated with pediatric onychophagia, defined as habitual nail biting, according to a recent study. Therefore, 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. 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. Researchers found:

  • Of 281 patients, 101 (37%) reported past or present nail biting lasting > 1 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.
  • 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).

Winebrake JP, Grover K, Halteh P, Lipner SR. Pediatric onychophagia: A survey-based study of prevalence, etiologies, and co-morbidities. Am J Clin Dermatol. 2018;19 (6):887–891. doi:10.1007/s40257-018-0386-1.