Introduction: Compulsive skin picking, being part of the broader category of impulse control disorders, is considered a residual diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. It is characterized by excessive scratching or picking of normal skin, or skin with minor surface irregularities, and occurs in 2% of patients attending dermatology clinics. Despite the clinical relevance of this disorder, no clear guidelines are available yet; clinical management is, therefore, compromised and the day-to-day clinical practice is burdened by difficulties. Studies on selective serotonin reuptake inhibitors and anti-epileptic drugs have provided limited results. The association between anti-depressants and anti-epileptics has been found to be beneficial in some impulse control disorders, but in skin picking no previous studies have been conducted on this pharmacological approach. There are very few reports on the efficacy of anti-psychotics in skin picking. Case presentation: The therapeutic path described in this case report produced good results for a 59-year-old Caucasian woman. The first therapeutic approach, with fluvoxamine and oxcarbazepine was partially effective; then, the suspension of oxcarbazepine and haloperidol augmentation of fluvoxamine were adopted. After 10 weeks, a significant improvement of the disease was observed: the clinical picture and the associated symptoms were nearly solved. Conclusions: To the best of our knowledge, this is the first article reporting the association of fluvoxamine and haloperidol in skin picking disorder. It might be useful to perform further research regarding the treatment of skin picking disorder: in clinical practice, several variables might limit the choice of certain drugs. Therefore, it would be useful for the clinician to be aware of other therapeutic options.

Background: Human health is closely interconnected to our ecosystem. Several studies found evidence that nature-based interventions improve mental health. Very recently, these approaches have started including mindfulness practices. Nature-based mindfulness interventions (NBMIs) combine contemplative practices with exposure to natural environments and are increasingly recognised as promising tools for supporting mental health and resilience within a One Health perspective, fostering physio-psychological wellbeing whilst promoting nature awareness and a sense of connection with our planet—“biofilia”, as defined by American biologist Edward Wilson. Given the growing psychological impacts of climate-related stressors, NBMIs may offer particular value for regions with high climate-risk and ecological vulnerability. Methods: A narrative literature review was conducted following established principles for high-quality non-systematic reviews. A non-systematic but structured search of PubMed, Scopus, Web of Science and Cochrane Library (January 2018–November 2025), complemented by grey literature, identified studies involving adolescents and adults participating in interventions integrating mindfulness practices with natural environments. Extracted data included study context, participant characteristics, intervention type, mental health and resilience outcomes. Results: Across heterogeneous designs, NBMIs consistently reduced stress, anxiety, depressive symptoms and rumination, while improving sleep, vitality, attention and self-regulation. Most studies reported enhanced nature connectedness—an important mediator of wellbeing and pro-environmental behaviour. Programmes delivered to disaster-affected populations showed reductions in distress. Conclusions: NBMIs are feasible, low-cost and adaptable interventions with dual benefits for mental health and ecological awareness. They offer promising One Health-aligned strategies for strengthening psychological resilience in climate-vulnerable regions, warranting further research and context-specific adaptation.