Excoriation of Skin Clinical Trial
Official title:
Randomized Controlled Trial of Group Psychodrama for Skin Picking
This study aims to evaluate the effectiveness of psychodrama group therapy (PGT) compared with supportive group therapy (SGT) for excoriation disorder (ED). Patients will be randomly allocated for either PGT or SGT. The Skin Picking Scale Revised (SPS-R) will be the primary outcome and emotional regulation measured by the Difficulties in Emotion Regulation Scale (DERS) will be evaluated as a potential intermediator. The Clinical Global Impression Scale (CGI); Beck Depression Scale (BDI); Beck Anxiety Scale (BAI), and the Social Adjustment Scale (EAS) will assess secondary outcomes.
Excoriation disorder (ED) is a diagnostic characterized by recurrent picking at one´s own
skin, resulting in skin lesions, despite repeated attempts to stop the behavior that causes
clinically significant distress or impairment in important areas of functioning. The skin
picking behavior is better accounted by physiological effects of a substance or better
explained by symptoms of another mental disorder.
Objective: This study aims to evaluate the effectiveness of psychodrama group therapy (PGT)
compared with supportive group therapy (SGT).
Justification: The scientific studies on treatment for ED are scarce and all associated with
behavioral therapy methods, which do not adequately consider underlying factors of ED, such
as emotional dysregulation. There are also not reports of group treatment for ED.
Method: patients who meet criteria for ED according to DSM-5 will be selected . Patients in
need of treatment for psychiatric comorbidities (such as anxiety and depression) will wait at
least 4 weeks until pharmacological prescription is stable. The subjects will be randomly
allocated to either PGT or SGT. The Skin Picking Scale Revised (SPS-R) will be the primary
outcome and emotional regulation measured by the Difficulties in Emotion Regulation Scale
(DERS) will be evaluated as a potential intermediator. The Clinical Global Impression Scale
(CGI); Beck Depression Scale (BDI); Beck Anxiety Scale (BAI), and the Social Adjustment Scale
(EAS) will assess secondary outcomes.
Hypotheses:
1. The PGT is more effective than SGT for the ED patient regarding the reduction of skin
excoriation behavior.
2. PGT is more effective than SGT for the ED patient regarding the improvement of the
symptoms of anxiety, depression and trichotillomania (when present).
3. The therapeutic effects of PGT is intermediated by emotional regulation.
;