Compulsive skin picking behaviours predict hypomanic subthreshold symptoms in a community sample

Background and Aims: Compulsive Skin Picking (SP) is a stronglyimpairing psychiatric condition characterized by repetitive picking behaviours, which result in significant tissue damage and distress. Research has identified a Focused SP subtype, typically occurring in response to negative emotions, an Automatic subtype, occurring without awareness during activities not related to the picking behaviour, and a Mixed one. No study has examined the relationship between SP behaviours and hypomanic symptoms. Understanding this connection may help to identify treatment strategies for cases presentingwith bipolar disorder spectrum symptoms and comorbid SP. Methods: In a community sample (N = 285, 71.20% women, mean age = 34.98 years, SD = 15.91), this cross-sectional study investigated whether compulsive skin picking behaviours could predict subthreshold hypomanic symptoms. Participants completed the Milwaukee Inventory for the Dimensions of Adult Skin Picking (MIDAS), Millon Clinical Multiaxial Inventory-III (MCMI-III), and Difficulties in Emotion Regulation Scale (DERS). A multiple linear regression analysis was performed entering the MCMI-III Bipolar Mania scores as outcomes and MIDAS and DERS as predictors. Results: Only higher scores on the MIDAS Automatic Skin Picking (b = 0.12, t = 2.16, p < 0.05) predicted significantly higher scores on the MCMI-III Bipolar Mania, but not scores on the MIDAS Focused and MIDAS Mixed scales. The effect remained significant even when the effect of DERS scores were controlled for (R2 = 29%). Conclusions: Subtype of automatic SP symptoms could be related to hypomanic symptoms. Treatment strategies for cases with Automatic SP and comorbid hypomanic symptoms are discussed. Future studies with clinical samples are required.