Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children

<p>Abstract</p> <p>Background</p> <p>Nail biting (NB) is a very common unwanted behavior. The majority of children are motivated to stop NB and have already tried to stop it, but are generally unsuccessful in doing so. It is a difficult behavior to modify or treat. The objective of this study was to investigate the prevalence of co-morbid psychiatric disorders in a clinical sample of children with NB who present at a child and adolescent mental healthcare outpatient clinic and the prevalence of psychiatric disorders in their parents.</p> <p>Method</p> <p>A consecutive sample of 450 referred children was examined for NB and 63 (14%) were found to have NB. The children and adolescents with nail biting and their parents were interviewed according to DSM-IV diagnostic criteria. They were also asked about lip biting, head banging, skin biting, and hair pulling behaviors.</p> <p>Results</p> <p>Nail biting is common amongst children and adolescents referred to a child and adolescent mental health clinic. The most common co-morbid psychiatric disorders in these children were attention deficit hyperactivity disorder (74.6%), oppositional defiant disorder (36%), separation anxiety disorder (20.6%), enuresis (15.6%), tic disorder (12.7%) and obsessive compulsive disorder (11.1%). The rates of major depressive disorder, mental retardation, and pervasive developmental disorder were 6.7%, 9.5%, 3.2%, respectively. There was no association between the age of onset of nail biting and the co-morbid psychiatric disorder. Severity and frequency of NB were not associated with any co-morbid psychiatric disorder. About 56.8% of the mothers and 45.9% of the fathers were suffering from at least one psychiatric disorder. The most common psychiatric disorder found in these parents was major depression.</p> <p>Conclusion</p> <p>Nail biting presents in a significant proportion of referrals to a mental healthcare clinic setting. Nail biting should be routinely looked for and asked for in the child and adolescent mental healthcare setting because it is common in a clinical population, easily visible in consultation and relatively unintrusive to ask about. If present, its detection can then be followed by looking for other more subtle stereotypic or self-mutilating behaviors.</p

Escala Razões para Fumar Modificada: tradução e adaptação cultural para o português para uso no Brasil e avaliação da confiabilidade teste-reteste Modified Reasons for Smoking Scale: translation to Portuguese, cross-cultural adaptation for use in Brazil and evaluation of test-retest reliability

OBJETIVO: Traduzir, fazer a adaptação cultural e testar a confiabilidade teste-reteste de uma versão em língua portuguesa da Escala Razões Para Fumar Modificada (ERPFM) para uso no Brasil. MÉTODOS: Uma versão em língua inglesa da ERPFM foi traduzida por médicos brasileiros com profundo conhecimento sobre a língua inglesa. Uma versão de consenso foi obtida por grupo multidisciplinar composto por dois pneumologistas, um psiquiatra e um psicólogo. Essa versão foi traduzida de volta ao inglês por um tradutor americano. A avaliação da adaptação cultural da versão final foi efetuada em uma amostra de 20 fumantes saudáveis. A avaliação da confiabilidade teste-reteste foi feita pela aplicação da versão traduzida da escala em 54 fumantes saudáveis em duas ocasiões separadas por 15 dias. RESULTADOS: Essa versão traduzida da ERPFM exibiu excelente identidade cultural, sendo bem compreendida por 95% dos fumantes. Os graus de concordância das respostas em duas ocasiões distintas foram quase perfeito para duas questões, substancial para dez questões, moderado para oito questões e discreto para uma questão. Os valores dos coeficientes de correlação intraclasse dos fatores motivacionais em duas ocasiões, empregando-se modelos teóricos previamente publicados, foram superiores a 0,7 em seis dos sete domínios. CONCLUSÕES: A presente versão da ERPFM exibe identidade cultural e confiabilidade teste-reteste satisfatórias, podendo ser de utilidade no tratamento e na avaliação de tabagistas em nosso meio.<br>OBJECTIVE: To translate the Modified Reasons for Smoking Scale (MRSS) to Portuguese, to submit it to cross-cultural adaptation for use in Brazil and to evaluate the test-retest reliability of the translated version. METHODS: An English-language version of the MRSS was translated to Portuguese by Brazilian doctors who have thorough knowledge of the English language. A consensus version was produced by a multidisciplinary group including two pulmonologists, a psychiatrist and a psychologist. This version was back-translated to English by an American translator. Cross-cultural adaptation of the final version was evaluated in a sample of 20 healthy smokers. Test-retest reliability was evaluated by applying the translated version of the scale in 54 healthy smokers on two distinct occasions, 15 days apart. RESULTS: This translated version of the MRSS was well understood by 95% of the smokers, indicating excellent cross-cultural equivalence. The degree of reliability of the answers in two different occasions was almost perfect for two questions, substantial for ten questions, moderate for eight questions, and low for one question. The intraclass correlation coefficients of the motivational factors obtained on the two different occasions, calculated according to previously published theoretical models, were higher than 0.7 for six of the seven subscales. CONCLUSIONS: The Portuguese-language version of the MRSS shows satisfactory cross-cultural equivalence and test-retest reliability. It can be a useful tool in the evaluation and treatment of smokers in Brazil