Are self-mutilation or compulsive skin picking signs of OCD?
Skin picking and other self-injurious behaviors do have some apparent similarities to OCD. The only other reason to consider them as part of the spectrum of OCD is that early pharmacologic dissection studies done by Judith Rapoport, MD, and colleagues, shows parallels to OCD.4,5 Namely, some of these same conditions responded preferentially to clomipramine (a serotonin reuptake inhibitor) and not to desipramine (a norepinephrine reuptake inhibitor). I think we have to be very wary about concluding pathophysiology of an illness based upon drug response data. That patients respond to the same treatment does not mean there is the same underlying etiology. The same system may be recruited to compensate for a deficit without actually correcting the underlying problem.
