Body-focused repetitive behaviours at the crossroads of medicine and psychiatry: prevalence and clinical characteristics in Paraguayan adults

Body-focused repetitive behaviours (BFRBs), including hair pulling and skin picking, occupy a clinically complex space at the intersection of medicine and psychiatry. Despite their association with psychological distress, functional impairment, and dermatological consequences, they remain under-recognised in many healthcare settings. This cross-sectional study aimed to estimate the prevalence and clinical characteristics of BFRBs in Paraguayan adults and to examine their relationship with perceived stress. A total of 301 participants completed an online survey, and severity was assessed using the Spanish-adapted Generic Body-Focused Repetitive Behavior Scale-8 (GBS-8). At least one self-reported body-focused repetitive behaviour (including subclinical manifestations) was reported by 59.1% of participants, although only 7.3% reported a prior clinical diagnosis. Among individuals endorsing a BFRB, 80.9% had never sought professional consultation. Greater BFRB severity was weakly but significantly associated with higher perceived stress. Confirmatory factor analysis supported a two-factor structure comprising symptom severity and impairment dimensions, and internal consistency was good. These findings highlight both the prevalence and relative invisibility of BFRBs and underscore their relevance within integrated models of care addressing the interdependence of mental and physical health.