Is nail biting, particularly chronic and compulsive nail biting that causes significant distress or impairment in daily life, officially classified as a mental disorder according to established diagnostic manuals like the DSM-5 or ICD-11? And if so, under what specific category is it classified, and what are the diagnostic criteria that differentiate it from a normal, occasional habit?

Answer

Yes, nail biting, also known as onychophagia, is officially classified as a mental disorder.

It is categorized under “Other Specified Obsessive-Compulsive and Related Disorder” in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), published by the American Psychiatric Association. This means that while it’s not a specific, standalone diagnosis, it falls under the umbrella of obsessive-compulsive and related disorders (OCRDs).

The DSM-5 criteria for OCRDs in general include:

* Recurrent body-focused repetitive behaviors (BFRBs) like nail biting.
* Repeated attempts to decrease or stop the behaviors.
* The behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
* The behaviors are not attributable to the physiological effects of a substance (e.g., stimulants) or another medical condition (e.g., skin condition).
* The behaviors are not better explained by the symptoms of another mental disorder.

Therefore, nail biting is considered a mental disorder when it is persistent, results in significant distress or impairment, and is not better explained by another condition. The severity can range from mild to severe.

While occasional nail biting is common and often considered a habit, chronic and compulsive nail biting that leads to tissue damage, social embarrassment, or functional impairment meets the criteria for a mental disorder according to the DSM-5.

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