소아청소년의 신체중심 반복행동장애에 대한 체계적 고찰: 중재 결과 중심

초록

Objectives: Body-focused repetitive behavior (BFRB) is characterized by repetitive, destructive behavior that cause significant distress or impairment in major functional domains. This systematic review aims to analyze existing research to conclude the efficacy of various treatment approaches for BFRB in children and adolescents. Methods: A systematic literature review was conducted using the PubMed and Embase databases up to December 10, 2024. 17 studies evaluating treatments for BFRB, including hair-pulling, skin-picking, nail-biting, lip- biting, and cheek-chewing in children and adolescents, were identified. Results: In accordance with PRISMA guidelines, studies were excluded based on eligibility criteria, result- ing in no studies identified for skin-picking, lip-biting, and cheek-chewing. The final analysis included 13 stud- ies on hair-pulling and 4 studies on nail-biting. For pediatric trichotillomania, psychosocial treatments demon- strated relatively higher efficacy, while pharmacological treatments, including N-acetylcysteine (NAC) and milk thistle, were also identified. NAC, however, showed only minimal efficacy. For nail-biting disorders, habit rever- sal training (HRT) was shown to be effective, and NAC was identified as a potential adjunctive treatment. Conclusions: Psychosocial treatments for pediatric and adolescent BFRB demonstrated relatively strong short- and long-term efficacy, whereas the effectiveness and research on pharmacological treatments remain lim- ited. Further research is needed to explore treatments for a broader range of BFRB in children and adolescents, particularly for under-studied subtypes such as skin-picking, lip-biting, and cheek-chewing.

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