PS04 The association between body-focused repetitive behaviours and psychiatric conditions: a scoping review

Abstract

Body-focused repetitive behaviours (BFRBs), including trichotillomania and excoriation disorder, are self-grooming behaviours that are repetitive and difficult to control and can result in physical harm and psychological distress. While associations between psychiatric conditions and skin disorders have been widely reported, the relationship between BFRBs and psychiatric disorders remains poorly characterized and underexplored. This scoping review aims to map the extent and nature of the available evidence on the association between BFRBs and psychiatric conditions. A comprehensive scoping review was conducted using PubMed, APA PsychINFO, Embase and Cochrane Library from inception to 2025. Peer-reviewed studies assessing BFRBs in individuals with psychiatric conditions were included. Following title, abstract and full-text screening, 62 studies were included from an initial 2327 records. Psychiatric comorbidity was common among individuals with BFRBs. A large systematic review and meta-analysis of 119 studies reported prevalence rates of 27.5% for any anxiety disorder, 19.2% for generalized anxiety disorder, 12.8% for obsessive–compulsive disorder and 10.6% for social anxiety disorder among individuals with BFRBs. The lifetime prevalence of any anxiety disorder was higher (35.9%), highlighting the chronic psychiatric burden in this population (Barber KE, Cram IF, Smith EC et al. Anxiety and body-focused repetitive behaviors: a systematic review and meta-analysis of comorbidity rates and symptom associations. J Psychiatr Res 2025; 181: 80–90). Attention deficit/hyperactivity disorder emerged as a prominent comorbidity across people of all ages, with a prevalence of 12–32% in patients with trichotillomania, excoriation disorder or both. Despite the high prevalence of psychiatric conditions among individuals with BFRBs, current UK clinical guidelines offer no provision for screening in patients with BFRBs. This review highlights the need for the integration of mental health screening for individuals presenting with BFRBs across psychiatric and dermatological settings.