Questão 13 - IDOMED Unificado medicina - presencial 2025/2

ONYCHOPHAGIA

 

    Onychophagia, or nail-biting, can be a temporary, relatively non-destructive behavior that is merely a cosmetic concern, but it can also develop into a severe, long-term problem. Onychophagia, or Onychophagy, is considered a pathological oral habit and grooming disorder characterized by chronic, seemingly uncontrollable nail-biting that is destructive to fingernails and their surrounding tissue. It is a relatively common problem, but the line between “normal” and pathological nailbiting is not always clear.

    According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), diagnosable “body-focused repetitive behavior disorder” (a category that includes Onychophagia) triggers clinically significant distress, interferes with functioning in at least one important life domain, and is characterized by repeated, failed attempts to stop the behaviors. Thus, those who feel intense shame, guilt, or anxiety about their nail-biting, feel unable to stop, and find that it interferes with one or more areas of their life may benefit from seeking treatment.

    Possible physical side effects of nail-biting include damaged or disfigured nails and skin, skin infections, fungal infections, and mouth pain or tooth damage. Individuals who swallow the bitten nails may be at risk for stomach or intestinal infections as well. Nails and fingers often carry bacteria or viruses, so, biting them may transmit pathogens into the body, potentially increasing the risk of internal infections or gastrointestinal problems.

    There may be a genetic link to Onychophagia, as some people appear to have an inherited tendency toward developing BFRB (Body-focused Repetitive Behavior), as well as higher-than-average rates of mood and anxiety disorders in immediate family members. This condition is, however, very frequently associated with anxiety, because the act of chewing on nails reportedly relieves stress, tension, or boredom. People who habitually bite their nails often report that they do so when they feel nervous, bored, lonely, or even hungry. It can be a habit transferred from earlier thumb or finger sucking as well and can occur without symptoms of another psychiatric condition. It can also be associated with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, separation anxiety, enuresis, tic disorder, and other mental health issues.

    Hiding one’s nails or making them unpleasant to bite – by cutting them short, painting them with bitter-tasting polish, or wearing gloves or mittens – can make it more difficult to engage in the behavior. It’s also helpful to identify one’s “trigger” – the emotion or situation that makes someone most prone to biting – and develop coping mechanisms to replace nail-biting with a healthier alternative. For example, someone who bites while bored could play with a fidget toy in situations where they’re likely to be bored and someone who bites when anxious could squeeze a stress ball or engage in a brief relaxation exercise instead of biting.

Available at: https://www.psychologytoday.com/us/conditions/onychophagia-nail-biting. Accessed on: 8th apr. 2025. (Adapted).

According to the second paragraph, considering the behavior associated with Onychophagia, people with this problem feel: