Psychiatric Comorbidities and the Risk of Suicide in Obsessive-Compulsive and Body Dysmorphic Disorder

Abstract

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that is characterized by obsessions and compulsions. Obsessions are uncontrollable distressful thoughts. Compulsions are recurrent behaviors or thoughts performed in an attempt to decrease the anxiety of the obsessions. Body dysmorphic disorder (BDD) is a mental disorder characterized by a distressful preoccupation with a perceived defect in appearance. The perceived flaw in appearance is minimal or unnoticed by others. BDD was considered an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). In the DSM-V, it was added to the obsessive-compulsive and related disorders category. The objective of this literature review was to explore the psychiatric comorbidities and the risk of suicide associated with OCD and BDD. Our study results showed OCD and BDD share common genetic and environmental risk factors, clinical features, and sociodemographic profiles. Both OCD and BDD are related disorders that commonly coexist. The suicide risk in OCD is increased as the intensity of the obsessions, trait perfectionism, and alexithymia increases. The suicide risk in BDD is increased by the presence of other disorders such as substance use disorder, major depressive disorder, eating and personality disorders. People with comorbid OCD-BDD have high morbidity, a decrease in insight and poor psychosocial functions. They have higher rates of anxiety, schizotypal features, and suicidal ideation compared to those with BDD or OCD alone.

Body Dysmorphic Disorder Symptoms: Prevalence and Risk Factors in an Arab Middle Eastern Population

“…BDD was found to have an increased risk of suicide based on the presence of other psychiatric comorbidities, including major depressive disorder and personality disorders. 25 Depression could develop due to having BDD, a result of prolonged anxiety and shame associated with BDD and the resulting social dysfunction. 18 Alternately, BDD may be more likely to develop in those with pre-existing depression due to greater sensitivity over physical appearance caused by depression.…”

Case Report: Effect of Electroconvulsive Therapy on Obsessive-Compulsive Disorder Comorbid With Body Dysmorphic Disorder

“…Patients with comorbid OCD-BDD have high morbidity, limited insight, and poor psychosocial outcomes ( 12 , 13 ). Moreover, rates of anxiety, schizotypal features, and suicidal ideation have been reported to be higher in patients with comorbid OCD-BDD than in those with BDD or OCD alone ( 13 , 14 ).…”

“…These comorbid psychiatric disorders add more challenges in terms of treatment. Depression is the most common comorbidity in patients with OCD, with a lifetime prevalence of 40–70% ( 12 ). Both depression and OCD are characterized by a chronic and/or recurrent course, leading to a profound deterioration in psychosocial functioning.…”

La obsesión por la belleza

“…Entre los cuadros asociados más frecuentemente se encuentran el trastorno depresivo mayor, las fobias sociales, adicciones a sustancias, trastorno obsesivo compulsivo, trastornos alimentarios, trastornos de personalidad y trastornos de ansiedad [19,26,27]. Hay que remarcar que muchas veces son pacientes que acaban hospitalizados por cuadros de autolesiones [28].…”