Onychophagia as a clinical symptom: A pilot study of physicians and literature review

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.

The effectiveness of a nail-biting prevention program among primary school students

PURPOSE

This study aimed to demonstrate the effect of a program called "Do Not Bite Your Nails, Cut Your Nails," which is based on a health promotion model to change the nail-biting habit among primary school students.

DESIGN AND METHODS

This quasi-experimental study was conducted using the pre- and post-test and interrupted time series design. The study sample included 299 students. Nurse observation form and nail follow-up chart were used to evaluate behavioral outcomes. This program was conducted under the guidance of school nurses and lasted 6 weeks. The data were analyzed using McNemar and Cochran Q tests.

RESULTS

The number of those who selected "yes" for "I cut my nails this weekend" and "I didn't bite my nails today" increased. However, the number of the students that selected "yes" for "I pulled out my nails," "I pulled out and ate," "I pulled out my nail skin," "My cuticle bled today," and "My nails hurt today" decreased significantly and statistically compared with pretest, first and second observation, and post-test (P < 0.001). The rate of the students with minimum one abnormal finger was 83.9% according to observations, and 6% following the intervention (P < 0.001). New insights were provided into the program to diminish nail-biting habit.

PRACTICE IMPLICATIONS

The program significantly reduced the nail-biting rate among primary school students. The nurse that implement this program will be able to do a comprehensive evaluation of students' nail-biting habits, perform solution-focused interventions, and prevent advanced complications that might develop in connection to nail-biting. Thus, the effectiveness of nursing implementations will improve in the prevention of nail-biting habit, early diagnosis, and changing students' habits. "Do Not Bite Your Nails, Cut Your Nails" program can be applied again in different schools.

Chronic Nail Biting in Youth

Nail biting, a common behavior seen in children, is typically short-lived and does not cause significant problems. However, when nail biting remains unresolved, physical and emotional consequences may occur. Exploring the etiological factors and underlying function of nail biting may help providers recommend appropriate interventions. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 23-26.].

The effect of psychological state and social support on nail-biting in adolescents: An exploratory study

Nail-biting is one of the most common behavioral problems in children. This study aimed to examine factors affecting nail-biting among adolescents and the effects of psychological state and social support on nail-biting. This cross-sectional study was conducted between January and May of 2014 in seven schools in Istanbul ( N = 724). Data were collected using the Personal Information Form, Brief Symptom Inventory, and Child and Adolescent Social Support Scale. This study found that 48.2% of adolescents in the 11- to 17-years-old age group had a habit of nail-biting. Anxiety, depression, negative self image, somatization, hostility, and three global index scores of adolescents who bit their nails were significantly higher than in those who did not. Social support scores of those who bit their nails were significantly lower than in those who did not in the ‘mother’ and ‘classmates’ subscales and total scores. Psychological state and social support were factors affecting nail-biting among adolescents.