Prevalence and clinical characteristics of body dysmorphic disorder in an adult inpatient setting

Abstract

Objective-Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, is an often-severe, understudied disorder. We determined BDD's prevalence and clinical features on a general adult psychiatric inpatient unit. To our knowledge, only one previous prevalence study has been done in this setting. Method-One hundred patients completed 3 self-report measures: the Body Dysmorphic Disorder Questionnaire (BDD-Q), Beck Anxiety Inventory (BAI) and Center for Epidemiologic Studies Depression Scale (CES-D). Those who screened positive for BDD were interviewed to confirm DSM-IV BDD and its clinical features. Charts were reviewed for demographic and clinical information.Results-BDD was diagnosed in 16.0% (95% CI=8.7-23.3%) (n=16) of patients. A high proportion of those with BDD reported that BDD symptoms contributed to suicidality. Patients revealed BDD symptoms to a mean of only 15.1%±33.7% lifetime mental health clinicians; only one (6.3%) reported symptoms to his current inpatient psychiatrist. Most did not disclose their symptoms due to embarrassment. Those with BDD were younger (P=.008) and had higher CES-D scores (P=.008). The two groups did not significantly differ on BAI score, demographic characteristics or discharge diagnoses.Conclusions-BDD is relatively common but underdiagnosed in psychiatric inpatients and is associated with more severe depressive symptoms.

Prevalence and Clinical Features of Body Dismorphic Disorder on Psychiatric Inpatients: A Cross-sectional Study in Edirne/TURKEY

“…In the American studies BDD prevalence was found to be 12.9-11%, in the German and the British studies the prevalence rates were 1.9% and 5.8%, respectively 8,[16][17][18] . Our findings are lower than the American studies whereas they are in accordance with the British study.…”

“…In these 4 studies prevalence rates vary between 16% and 1.9%. This high range in prevalence might be both due to cultural differences and methodological differences 8,[16][17][18][19] . In our study we both aimed to evaluate the prevalence in Turkey and decrease the literatural ambiguity.…”

Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women

“…For a second opinion a psychiatrist, who was experienced in diagnosing BDD, could be consulted via telephone. As the physical defect must be nonexistent or slight to meet the diagnostic criteria, the women's perceived appearance flaws were assessed by the interviewer using a Likert-scale, similar to rating scales used in previous research (Dufresne et al, 2001;Conroy et al, 2008;Conrado et al, 2010). The scale ranged from 1 to 3; 1 = no flaw present, 2 = minimal/slight flaw present, 3 = flaw present and clearly noticeable within conversational distance.…”

“…Using structured clinical interviews examining community samples, prevalence rates of 0.7-3% have been reported (Faravelli et al, 1997;Bienvenu et al, 2000;Otto et al, 2001). Studies of psychiatric samples have reported BDD in 2.6-16.0% of patients (Zimmerman and Mattia, 1998;Grant et al, 2001;Conroy et al;, Kollei et al, 2011. In dermatology settings, most studies have found BDD rates of 8.8-14% (Phillips et al, 2000;Uzun et al, 2003;Bowe et al, 2007).…”

“…Subsequently the BDDQ has been widely used for BDD screening, e.g. with 1000 dermatology and plastic surgery outpatients (Vulink et al, 2006), 100 psychiatric inpatients (Conroy et al, 2008), 160 patients with maxillofacial problems (Vulink et al, 2008) and 300 dermatological patients (Conrado et al, 2010).…”