Prevalence, phenomenology and comorbidity of body dysmorphic disorder (dysmorphophobia) in a clinical population

Abstract

Dysmorphophobia (body dysmorphic disorder), defined as a preoccupation with an imaginary or minimal defect in appearance, has been known for more than a century but has received relatively little empirical study. The authors investigated the demographics, phenomenology, course, associated psychopathology and family history in a series of 58 patients (34 men and 24 women) with the disorder. The patients were assessed with the Hopkins Symptom Checklist and two specially constructed instruments developed by the authors. The mean age at onset of body dysmorphic disorder was 17 (sd = 3.8) years and the average duration was 9 (sd = 5.3) years. The most common preoccupations were defects of the face, nose, genitals and legs. Seventy-nine percent of the patients reported excessive mirror checking and 53% reported attempts to camouflage their 'deformities'. As a result of their symptoms, 89.6% avoided the usual social activities, 51.7% showed an impairment of their academic or job performance, 45% experienced suicidal ideation and 36% showed aggressive behaviour. Seventy-two percent of the patients had an associated lifetime diagnosis of a major mood disorder and 74% of an anxiety disorder. Body dysmorphic disorder has a generally chronic course, causes considerable distress and a serious impairment in many areas, and shows strong links with mood and obsessive-compulsive disorders.

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

“…This finding is consistent with studies of out-patients ascertained for BDD, in which 45-70% reported a history of suicidal ideation attributed primarily to BDD [39,40], and 16% (of 100 subjects) attributed at least one suicide attempt primarily to BDD [40]. A limitation of the present study is that we did not obtain suicidality data in patients without BDD and thus cannot compare suicidality in patients with and without BDD.…”

Severity of Interpersonal Problems in Individuals with Body Dysmorphic Disorder

“…Our finding in the present study that BDD subjects had above average scores on the Vindictive/Self-Centered subscale-and that BDD severity was modestly correlated with scores on this subscale-is consistent with these prior findings. In a study of 58 adults with BDD, 36% reported physical aggression attributed to their BDD symptoms (Perugi et al, 1997). Clinical observations indicate that hostility/aggression may be fueled by anger about looking "abnormal," an inability to fix the perceived appearance defects, feeling rejected because of one's appearance "defects," and delusions of reference (e.g., believing that others are talking about them because of their appearance) (Phillips, Siniscalchi, et al, 2004).…”

‘I will be at death’s door and realize that I’ve wasted maybe half of my life on one body part’: the experience of living with body dysmorphic disorder

“…Quantitative studies have demonstrated that the condition leads to impaired functioning in relationships, socializing, and intimacy as well as to a decreased ability to function at work, in school, or in other daily activities (Perugi et al 1997;Phillips 2009). BDD is associated with significant distress, shame, disability, and suicidality (Crerand et al 2005;Fang and Wilhelm 2015;Phillips 1991;2007;Phillips and Menard 2006).…”