<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2664-2891</journal-id>
<journal-title><![CDATA[Revista científica ciencias de la salud]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. cient. cienc. salud]]></abbrev-journal-title>
<issn>2664-2891</issn>
<publisher>
<publisher-name><![CDATA[Universidad del Pacífico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2664-28912025000100114</article-id>
<article-id pub-id-type="doi">10.53732/rccsalud/2025.e7114</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Conductas repetitivas orientadas al cuerpo y su asociación con síntomas de depresión, ansiedad y estrés en estudiantes de medicina paraguayos: un estudio transversal]]></article-title>
<article-title xml:lang="en"><![CDATA[Body-Focused Repetitive Behaviors and Their Association with Symptoms of Depression, Anxiety, and Stress in Paraguayan Medical Students: A Cross-Sectional Study]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barrios]]></surname>
<given-names><![CDATA[Iván]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Estigarribia]]></surname>
<given-names><![CDATA[Gladys]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araujo]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ávalos]]></surname>
<given-names><![CDATA[Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coronel]]></surname>
<given-names><![CDATA[Cristian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[Charlis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[O´Higgins]]></surname>
<given-names><![CDATA[Marcelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caycho-Rodríguez]]></surname>
<given-names><![CDATA[Tomás]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ventriglio]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castaldelli-Maia]]></surname>
<given-names><![CDATA[João Mauricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torales]]></surname>
<given-names><![CDATA[Julio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A8"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas - Filial Santa Rosa del Aguaray ]]></institution>
<addr-line><![CDATA[Santa Rosa del Aguaray ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Sudamericana Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Pedro Juan Caballero ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional de Caaguazú Instituto Regional de Investigación en Salud ]]></institution>
<addr-line><![CDATA[Coronel Oviedo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Científica del Sur  ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Peru</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,University of Foggia Department of Clinical and Experimental Medicine ]]></institution>
<addr-line><![CDATA[Foggia ]]></addr-line>
<country>Italy</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,University of São Paulo Department of Psychiatry ]]></institution>
<addr-line><![CDATA[São Paulo ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Universidad de Los Lagos Vicerrectoría de Investigación y Postgrado ]]></institution>
<addr-line><![CDATA[Osorno ]]></addr-line>
<country>Chile</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>7</volume>
<fpage>114</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2664-28912025000100114&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2664-28912025000100114&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2664-28912025000100114&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Introducción. Las conductas repetitivas orientadas al cuerpo (BFRB, por sus siglas en inglés), como la tricotilomanía y el trastorno de excoriación, afectan significativamente la calidad de vida, el bienestar psicológico y el rendimiento académico. Sin embargo, la investigación sobre su asociación con síntomas de salud mental en estudiantes de medicina paraguayos es limitada. Objetivo. Describir la frecuencia de BFRB en estudiantes de medicina y su asociación con síntomas de depresión, ansiedad y estrés. Materiales y Métodos. Estudio observacional con 158 estudiantes de medicina de Paraguay, seleccionados mediante muestreo no probabilístico por conveniencia. Se utilizaron instrumentos validados en español, como la Skin Picking Scale-Revised, la Massachusetts General Hospital Hair Pulling Scale y la Depression Anxiety Stress Scale-21. Las asociaciones entre variables se evaluaron con la prueba de chi cuadrado (nivel de significancia del 5 %). Resultados. La prevalencia del trastorno de excoriación fue del 22,8 % y la de tricotilomanía del 7 %. El 63,3 % de los estudiantes presentó depresión, el 62,7 % ansiedad y el 56,3 % estrés. La depresión aumentó nueve veces las probabilidades de trastorno de excoriación (OR = 9,03; p &lt; 0,001), mientras que la ansiedad (OR = 4,9; p &lt; 0,001) y el estrés (OR = 5,34; p &lt; 0,001) también mostraron asociaciones significativas. La tricotilomanía no se asoció con estos síntomas. Conclusión. La alta prevalencia de BFRB y su asociación con síntomas de salud mental subraya la necesidad de intervenciones específicas en estudiantes de medicina para mejorar su bienestar psicológico y rendimiento académico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Introduction. Body-focused repetitive behaviors (BFRBs), such as trichotillomania and excoriation disorder, significantly impact quality of life, psychological well-being, and academic performance. However, research on their association with mental health symptoms in Paraguayan medical students is limited. Objective. To describe the prevalence of BFRBs in medical students and their association with symptoms of depression, anxiety, and stress. Materials and Methods. This was an observational study involving 158 medical students in Paraguay, selected through non-probabilistic convenience sampling. Validated Spanish-language instruments were used, including the Skin Picking Scale-Revised, the Massachusetts General Hospital Hair Pulling Scale, and the Depression Anxiety Stress Scale-21. Associations between variables were assessed using the chi-square test (significance level of 5%). Results. The prevalence of excoriation disorder was 22.8%, and that of trichotillomania was 7%. Depression was present in 63.3% of students, anxiety in 62.7%, and stress in 56.3%. Depression increased the odds of excoriation disorder ninefold (OR = 9.03; p &lt; 0.001), while anxiety (OR = 4.9; p &lt; 0.001) and stress (OR = 5.34; p &lt; 0.001) also showed significant associations. Trichotillomania was not associated with these symptoms. Conclusion. The high prevalence of BFRBs and their association with mental health symptoms highlight the need for targeted interventions in medical students to improve their psychological well-being and academic performance.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[conductas repetitivas orientadas al cuerpo]]></kwd>
<kwd lng="es"><![CDATA[depresión]]></kwd>
<kwd lng="es"><![CDATA[ansiedad]]></kwd>
<kwd lng="es"><![CDATA[estrés]]></kwd>
<kwd lng="es"><![CDATA[estudiantes de medicina]]></kwd>
<kwd lng="es"><![CDATA[Paraguay]]></kwd>
<kwd lng="en"><![CDATA[body-focused repetitive behaviors]]></kwd>
<kwd lng="en"><![CDATA[depression]]></kwd>
<kwd lng="en"><![CDATA[anxiety]]></kwd>
<kwd lng="en"><![CDATA[stress]]></kwd>
<kwd lng="en"><![CDATA[medical students]]></kwd>
<kwd lng="en"><![CDATA[Paraguay]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grant]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Chamberlain]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trichotillomania and Skin-Picking Disorder: An Update]]></article-title>
<source><![CDATA[Focus (Am Psychiatr Publ)]]></source>
<year>2021</year>
<volume>19</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>405-12</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jafferany]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mkhoyan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Arora]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sadoughifar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Jorgaqi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Goldust]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of skin picking disorder: Interdisciplinary role of dermatologist and psychiatrist]]></article-title>
<source><![CDATA[Dermatol Ther]]></source>
<year>2020</year>
<volume>33</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Houghton]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Alexander]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Woods]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Body-focused repetitive behaviors: More prevalent than once thought?]]></article-title>
<source><![CDATA[Psychiatry Res]]></source>
<year>2018</year>
<volume>270</volume>
<page-range>389-93</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tucker]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Woods]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Flessner]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Franklin]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Franklin]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Skin Picking Impact Project: phenomenology, interference, and treatment utilization of pathological skin picking in a population-based sample]]></article-title>
<source><![CDATA[J Anxiety Disord]]></source>
<year>2011</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>88-95</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abdulghani]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[AlKanhal]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Mahmoud]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Ponnamperuma]]></surname>
<given-names><![CDATA[GG]]></given-names>
</name>
<name>
<surname><![CDATA[Alfaris]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia]]></article-title>
<source><![CDATA[J Health Popul Nutr]]></source>
<year>2011</year>
<volume>29</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>516-22</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Siddiqui]]></surname>
<given-names><![CDATA[EU]]></given-names>
</name>
<name>
<surname><![CDATA[Naeem]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Naqvi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of body-focused repetitive behaviors in three large medical colleges of Karachi: a cross-sectional study]]></article-title>
<source><![CDATA[BMC Res Notes]]></source>
<year>2012</year>
<volume>5</volume>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quek]]></surname>
<given-names><![CDATA[TT]]></given-names>
</name>
<name>
<surname><![CDATA[Tam]]></surname>
<given-names><![CDATA[WW]]></given-names>
</name>
<name>
<surname><![CDATA[Tran]]></surname>
<given-names><![CDATA[BX]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis]]></article-title>
<source><![CDATA[Int J Environ Res Public Health]]></source>
<year>2019</year>
<volume>16</volume>
<numero>15</numero>
<issue>15</issue>
</nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Torales]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Kadhum]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zárate]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Barrios]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Farrell]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Wellbeing and mental health among medical students in Paraguay]]></article-title>
<source><![CDATA[Int Rev Psychiatry]]></source>
<year>2019</year>
<volume>31</volume>
<numero>7-8</numero>
<issue>7-8</issue>
<page-range>598-602</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Siddiqui]]></surname>
<given-names><![CDATA[EU]]></given-names>
</name>
<name>
<surname><![CDATA[Naeem]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Naqvi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of body-focused repetitive behaviors in three large medical colleges of Karachi: a cross-sectional study]]></article-title>
<source><![CDATA[BMC Res Notes]]></source>
<year>2012</year>
<volume>5</volume>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sailly]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Khanande]]></surname>
<given-names><![CDATA[RV]]></given-names>
</name>
<name>
<surname><![CDATA[Munda]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Mehta]]></surname>
<given-names><![CDATA[VS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Body-focused repetitive behaviors in school-going children and adolescents and its relationship with state-trait anxiety and life events]]></article-title>
<source><![CDATA[Indian J Psychiatry]]></source>
<year>2020</year>
<volume>62</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>703-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lochner]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Roos]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[D. J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Excoriation (skin-picking) disorder: a systematic review of treatment options]]></article-title>
<source><![CDATA[Neuropsychiatr Dis Treat]]></source>
<year>2017</year>
<volume>13</volume>
<page-range>1867-72</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Snorrason]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Belleau]]></surname>
<given-names><![CDATA[E. L.]]></given-names>
</name>
<name>
<surname><![CDATA[Woods]]></surname>
<given-names><![CDATA[D. W.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How related are hair pulling disorder (trichotillomania) and skin picking disorder (excoriation)? A review of evidence for comorbidity, similarities and shared etiology]]></article-title>
<source><![CDATA[Clin Psychol Rev]]></source>
<year>2012</year>
<volume>32</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>618-29</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Okumu&#351;]]></surname>
<given-names><![CDATA[H. G.]]></given-names>
</name>
<name>
<surname><![CDATA[Akdemir]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Body Focused Repetitive Behavior Disorders: Behavioral Models and Neurobiological Mechanisms]]></article-title>
<source><![CDATA[Turk Psikiyatri Derg]]></source>
<year>2023</year>
<volume>34</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>50-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramezani]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[Norouzi]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Arabshahi]]></surname>
<given-names><![CDATA[S. K. S.]]></given-names>
</name>
<name>
<surname><![CDATA[Sohrabi]]></surname>
<given-names><![CDATA[Z.]]></given-names>
</name>
<name>
<surname><![CDATA[Zazoli]]></surname>
<given-names><![CDATA[A. Z.]]></given-names>
</name>
<name>
<surname><![CDATA[Saravani]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Study of medical students' learning approaches and their association with academic performance and problem-solving styles]]></article-title>
<source><![CDATA[J Educ Health Promot]]></source>
<year>2022</year>
<volume>11</volume>
<page-range>252</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barber]]></surname>
<given-names><![CDATA[K. E.]]></given-names>
</name>
<name>
<surname><![CDATA[Cram]]></surname>
<given-names><![CDATA[I. F.]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[E. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Capel]]></surname>
<given-names><![CDATA[L. K.]]></given-names>
</name>
<name>
<surname><![CDATA[Snorrason]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Woods]]></surname>
<given-names><![CDATA[D. W.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anxiety and body-focused repetitive behaviors: A systematic review and meta-analysis of comorbidity rates and symptom associations]]></article-title>
<source><![CDATA[J Psychiatr Res]]></source>
<year>2025</year>
<volume>181</volume>
<page-range>80-90</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Setia]]></surname>
<given-names><![CDATA[M. S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Methodology Series Module 3: Cross-sectional Studies]]></article-title>
<source><![CDATA[Indian J Dermatol]]></source>
<year>2016</year>
<volume>61</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>261-4</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barrios]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Jafferany]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz Diaz]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
<name>
<surname><![CDATA[Castaldelli-Maia]]></surname>
<given-names><![CDATA[J. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Ventriglio]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Torales]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Psychometric properties of the Spanish version of the Skin Picking Scale-Revised (SPS-R)]]></article-title>
<source><![CDATA[J Obsessive Compuls Relat Disord]]></source>
<year>2020</year>
<volume>27</volume>
<page-range>100586</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Keuthen]]></surname>
<given-names><![CDATA[N. J.]]></given-names>
</name>
<name>
<surname><![CDATA[O'Sullivan]]></surname>
<given-names><![CDATA[R. L.]]></given-names>
</name>
<name>
<surname><![CDATA[Ricciardi]]></surname>
<given-names><![CDATA[J. N.]]></given-names>
</name>
<name>
<surname><![CDATA[Shera]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Savage]]></surname>
<given-names><![CDATA[C. R.]]></given-names>
</name>
<name>
<surname><![CDATA[Borgmann]]></surname>
<given-names><![CDATA[A. S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Massachusetts General Hospital (MGH) Hairpulling Scale: 1. development and factor analyses]]></article-title>
<source><![CDATA[Psychother Psychosom]]></source>
<year>1995</year>
<volume>64</volume>
<numero>3-4</numero>
<issue>3-4</issue>
<page-range>141-5</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[K&#322;osowska]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<name>
<surname><![CDATA[Sznajder]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Antosz-Rekucka]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Tuleja]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Prochwicz]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reliability, Validity and Factor Structure of the Polish Version of the Massachusetts General Hospital Hair Pulling Scale]]></article-title>
<source><![CDATA[Cogn Ther Res]]></source>
<year>2024</year>
<volume>48</volume>
<page-range>4-17</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[T. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Chorpita]]></surname>
<given-names><![CDATA[B. F.]]></given-names>
</name>
<name>
<surname><![CDATA[Korotitsch]]></surname>
<given-names><![CDATA[W.]]></given-names>
</name>
<name>
<surname><![CDATA[Barlow]]></surname>
<given-names><![CDATA[D. H.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples]]></article-title>
<source><![CDATA[Behav Res Ther]]></source>
<year>1997</year>
<volume>35</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>79-89</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz]]></surname>
<given-names><![CDATA[F. J.]]></given-names>
</name>
<name>
<surname><![CDATA[García Martín]]></surname>
<given-names><![CDATA[M. B.]]></given-names>
</name>
<name>
<surname><![CDATA[Suárez Falcón]]></surname>
<given-names><![CDATA[J. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Odriozola González]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Hierarchical Factor Structure of the Spanish Version of Depression Anxiety and Stress Scale]]></article-title>
<source><![CDATA[Int J Psychol Psychol Ther]]></source>
<year>2017</year>
<volume>17</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>97-105</page-range></nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barrios]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Miltos]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Piris]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Piris]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tamizaje de salud mental mediante el test M.I.N.I. en estudiantes del ciclo básico de medicina de la Universidad Nacional de Asunción]]></article-title>
<source><![CDATA[An Fac Cienc Méd (Asunción)]]></source>
<year>2015</year>
<volume>48</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>59-68</page-range></nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñoz Navarro]]></surname>
<given-names><![CDATA[S. R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[¿Cuántos sujetos necesito para mi estudio?]]></article-title>
<source><![CDATA[Medwave]]></source>
<year>2014</year>
<volume>14</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>e5995</page-range></nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melese]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
<name>
<surname><![CDATA[Bayu]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
<name>
<surname><![CDATA[Wondwossen]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
<name>
<surname><![CDATA[Tilahun]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
<name>
<surname><![CDATA[Lema]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Ayehu]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study]]></article-title>
<source><![CDATA[BMC Res Notes]]></source>
<year>2016</year>
<volume>9</volume>
<page-range>485</page-range></nlm-citation>
</ref>
<ref id="B25">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahgoub]]></surname>
<given-names><![CDATA[Y.]]></given-names>
</name>
<name>
<surname><![CDATA[Daher-Nashif]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Shebly]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Wali]]></surname>
<given-names><![CDATA[H. S.]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Almarkhi]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence and Determinants of Mental Health Problems and Mental Health Stigma Among Medical Students of Different Nationalities in Qatar]]></article-title>
<source><![CDATA[Adv Med Educ Pract]]></source>
<year>2022</year>
<volume>13</volume>
<page-range>969-79</page-range></nlm-citation>
</ref>
<ref id="B26">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chilavert]]></surname>
<given-names><![CDATA[C. M. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Monges]]></surname>
<given-names><![CDATA[A. E. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Villalba]]></surname>
<given-names><![CDATA[C. A. L.]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez]]></surname>
<given-names><![CDATA[G. A. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[M. S.]]></given-names>
</name>
<name>
<surname><![CDATA[Minck]]></surname>
<given-names><![CDATA[A. D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Niveles de depresión, ansiedad y estrés en estudiantes universitarios de la carrera de Ciencias Médicas de la Universidad del Pacífico Filial Pedro Juan Caballero]]></article-title>
<source><![CDATA[Medicinae Signum]]></source>
<year>2022</year>
<volume>1</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>10-8</page-range></nlm-citation>
</ref>
<ref id="B27">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gadi]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
<name>
<surname><![CDATA[Saleh]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[J. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Trinidade]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of the COVID-19 pandemic on the lifestyle and behaviours, mental health and education of students studying healthcare-related courses at a British university]]></article-title>
<source><![CDATA[BMC Med Educ]]></source>
<year>2022</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>115</page-range></nlm-citation>
</ref>
<ref id="B28">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hale]]></surname>
<given-names><![CDATA[E. W.]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[R. A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Supporting the future of medicine: Student mental health services in medical school]]></article-title>
<source><![CDATA[Front Health Serv]]></source>
<year>2023</year>
<volume>3</volume>
<page-range>1032317</page-range></nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tondehal]]></surname>
<given-names><![CDATA[N. R.]]></given-names>
</name>
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Reddy]]></surname>
<given-names><![CDATA[J. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Srinivas]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Sasikala]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assessment of Mental Health Status Among Medical Graduates During COVID-19 Lockdown Period: A Cross-Sectional Study]]></article-title>
<source><![CDATA[Natl J Lab Med]]></source>
<year>2021</year>
<volume>10</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>18-20</page-range></nlm-citation>
</ref>
<ref id="B30">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Olum]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Nakwagala]]></surname>
<given-names><![CDATA[F. N.]]></given-names>
</name>
<name>
<surname><![CDATA[Odokonyero]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia y factores asociados a la depresión entre estudiantes de medicina de la Universidad de Makerere, Uganda]]></article-title>
<source><![CDATA[Adv Med Educ Pract]]></source>
<year>2020</year>
<volume>11</volume>
<page-range>853-60</page-range></nlm-citation>
</ref>
<ref id="B31">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Simpson]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Halpin]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Chalmers]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
<name>
<surname><![CDATA[Joynes]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Explorando el bienestar: estudiantes y personal médico]]></article-title>
<source><![CDATA[Clin Teach]]></source>
<year>2019</year>
<volume>16</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>356-61</page-range></nlm-citation>
</ref>
<ref id="B32">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kihumuro]]></surname>
<given-names><![CDATA[R. B.]]></given-names>
</name>
<name>
<surname><![CDATA[Kaggwa]]></surname>
<given-names><![CDATA[M. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Nakandi]]></surname>
<given-names><![CDATA[R. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Kintu]]></surname>
<given-names><![CDATA[T. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Muwanga]]></surname>
<given-names><![CDATA[D. R.]]></given-names>
</name>
<name>
<surname><![CDATA[Muganzi]]></surname>
<given-names><![CDATA[D. J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perspectivas sobre los servicios de salud mental para estudiantes de medicina en una facultad de medicina ugandesa]]></article-title>
<source><![CDATA[BMC Med Educ]]></source>
<year>2022</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>734</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
