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Results for “Body Dysmorphic Disorders”

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PubMedDate not supplied

[Results of long-term observation (3-11 years) of patients with dual diagnosis: body dysmorphic disorder and delusional disorder, somatic type].

This work presents results of a retrospective and prospective research of 15 persons with a double diagnosis: body dysmorphic disorder, and delusional disorder, somatic type. It was established that these disorders starting in adolescence, occurred in persons who earlier had traits of avoidant and obsessive-compulsive personality or social phobia. In most subjects with dysmorphophobia there was comorbidity of dysthymia or major depression. An improvement in the state of these patients, most often after implementation of complex therapeutic measures: psychotherapy as well as pharmacotherapy with neuroleptic and SSRI's or clomipramine has to do with withdrawal of delusions, whereas the symptoms of body dysmorphic disorder usually last for years. In some patients delusional disorders had a tendency to reoccur or to be chronic, and lead to a considerable impairment of social functioning.

Adolescent↗
PubMed2006

[Body dysmorphic disorder in 3-8% of patients in outpatient dermatology and plastic surgery clinics].

OBJECTIVE: To determine the 6-month prevalence of body dysmorphic disorder (BDD) in outpatient clinics of dermatology and plastic surgery in a university medical centre. DESIGN: Questionnaire study. METHOD: In the period January 2004-June 2004, the self-reported Body dysmorphic disorder questionnaire was completed by 530 and 475 new patients in the outpatient clinics of dermatology and plastic surgery, respectively. The dermatologist or plastic surgeon assessed the severity of the defect. To meet the DSM-IV criteria for BDD, the patient must have been preoccupied with treatment of all or part of their appearance, experienced obvious suffering or restriction of function with minimal or no defect present (defect score 1 or 2). RESULTS: In the outpatient clinics ofdermatology and plastic surgery 8.5% (95% CI: 6.1-10.9) and 3.2% (95% CI: 1.7-4.7) of patients screened positive for BDD, respectively. CONCLUSION: A high prevalence of BDD was found in the outpatient clinics ofdermatology and plastic surgery. Because dermatologists and plastic surgeons do not often recognise BDD, a simple screening tool is needed.

Adolescent↗
PubMed1989

Treatment of body-dysmorphic disorder with serotonin reuptake blockers.

The authors describe five patients with body-dysmorphic disorder who responded preferentially to serotonin reuptake blockers. They review the literature, describe how patients with excessive concern about body abnormalities lie along a spectrum of doubt and certainty, and discuss similarities and differences between this disorder and obsessive-compulsive disorder.

Adult↗
PubMed2000

The links between body dysmorphic disorder and eating disorders.

The aim of the study was to search for a body dysmorphic disorder (BDD) period preceding the symptoms meeting the criteria of either anorexia or bulimia nervosa, and an evaluation of the prevalence of BDD symptoms in a control group of girls without any eating disorder. Ninety-three girls (12-21 years old ) were included in the study (36 with anorexia nervosa, 17 with bulimia nervosa and 40 healthy controls). The Structured Clinical Interview (SCID), including the BDD module, and a novel questionnaire (for the presence of preceding life events) were used. We found the symptoms of BDD in 25% of anorexia nervosa sufferers for at least six months before observing a clear eating disorder picture. Moreover, other mental disorders were also present among these patients. The results may support the idea that BDD and anorexia nervosa both belong to either OCD or affective disorders spectra.

Adolescent↗
PubMed1997

A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale.

The authors developed the Yale Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS), a 12-item semistructured clinician-rated instrument designed to rate severity of body dysmorphic disorder (BDD). The scale was administered to 125 subjects with BDD, and interviews with 15 subjects were rated by 3 other raters. Test-retest reliability was assessed in 30 subjects. Other scales were administered to assess convergent and discriminant validity, and sensitivity to change was evaluated in a study of fluvoxamine. Each item was frequently endorsed across a range of severity. Good interrater reliability, test-retest reliability, and internal consistency were obtained. BDD-YBOCS scores correlated with global severity scores but not with a measure of general psychopathology; they were modestly positively correlated with depression severity scores. Three factors accounted for 59.6 percent of the variance. The scale was sensitive to change in BDD severity. The BDD-YBOCS appears to be a reliable and valid measure of BDD severity and is a suitable outcome measure in treatment studies of BDD.

Adult↗
PubMed2006

Childhood abuse and neglect in body dysmorphic disorder.

OBJECTIVE: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder. METHODS: Seventy-five subjects (69.3% female, mean age=35.4+/-12.0) with DSM-IV BDD completed the Childhood Trauma Questionnaire and were interviewed with other reliable and valid measures. RESULTS: Of these subjects, 78.7% reported a history of childhood maltreatment: emotional neglect (68.0%), emotional abuse (56.0%), physical abuse (34.7%), physical neglect (33.3%), and sexual abuse (28.0%). Forty percent of subjects reported severe maltreatment. Among females (n=52), severity of reported abuse and neglect were .32-.57 standard deviation units higher than norms for a health maintenance organization (HMO) sample of women. Severity of sexual abuse was the only type of maltreatment significantly associated with current BDD severity (r=.23, p=.047). However, severity of sexual abuse did not predict current BDD severity in a simultaneous multiple regression analysis with age and current treatment status. There were other significant associations with childhood maltreatment: history of attempted suicide was related to emotional (p=.004), physical (p=.014), and sexual abuse (p=.038). Childhood emotional abuse was associated with a lifetime substance use disorder (r=.26, p=.02), and physical abuse was negatively associated with a lifetime mood disorder (r=-.37, p=.001). CONCLUSIONS: A high proportion of individuals with BDD reported childhood abuse and neglect. Certain types of abuse and neglect appear modestly associated with BDD symptom severity and with gender, suicidality, and certain disorders.

Adult↗
PubMed2001

Effectiveness of pharmacotherapy for body dysmorphic disorder: a chart-review study.

BACKGROUND: Research on the pharmacotherapy of body dysmorphic disorder (BDD) is limited. No placebo-controlled, continuation, maintenance, or discontinuation studies have been published. Only one augmentation study has been published. METHOD: In this chart-review study of 90 patients with DSM-IV BDD treated for up to 8 years by the first 2 authors (K.A.P., R.S.A.) in their clinical practice, response to a variety of medications, including augmentation strategies, was assessed. The relapse rate with medication discontinuation was also determined. RESULTS: All subjects received a serotonin reuptake inhibitor (SRI), with 63.2% (55/87) of adequate SRI trials resulting in improvement in BDD symptoms; similar response rates were obtained for each type of SRI. Discontinuation of an effective SRI resulted in relapse in 83.8% (31/37) of cases. Response rates to selective SRI augmentation were clomipramine, 44.4% (4/9) of trials; buspirone, 33.3% (12/36) of trials; lithium, 20.0% (1/5); methylphenidate, 16.7% (1/6); and antipsychotics, 15.4% (2/13) of trials. CONCLUSION: These findings from a clinical setting suggest that a majority of BDD patients improve with an SRI and that all SRIs appear effective. Certain SRI augmentation strategies may be beneficial. The high relapse rate with SRI discontinuation suggests that long-term treatment is often necessary. These preliminary findings require confirmation in placebo-controlled efficacy studies and effectiveness studies.

Adolescent↗
PubMed1996

Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia).

Fifteen consecutive patients with a DSM-III-R diagnosis of body dysmorphic disorder (BDD) were included in a 10-week open clinical trial of fluvoxamine. Treatment began at 100 mg/day fluvoxamine and was increased to a maximum of 300 mg/day or until intolerable side effects developed or a complete or nearly complete resolution of symptoms occurred. At baseline and at weeks 2, 6 and 10, patients completed the Hopkins Symptoms Check-List (HSCL-90) and a specific rating scale for BDD symptoms (BDDSS), and clinicians completed a Clinical Global Improvement Scale. Twelve of the 15 patients completed the trial. Of the three patients who did not complete the study, one improved moderately during the placebo phase, one showed a marked worsening of the depressive symptoms during the wash-out phase and one showed adverse side effects, such as nausea and diarrhoea, after the first week of treatment and was unable to continue the trial. After 10 weeks, of the 12 remaining patients, 10 were considered to be markedly improved, one minimally improved and one unchanged. Several outcome measures showed a significant improvement from baseline to week 10. Our findings suggest that fluvoxamine may be effective in the treatment of BDD. Double-blind studies will be required to investigate these findings further.

Adolescent↗
PubMed2005

Delusional versus nondelusional body dysmorphic disorder: clinical features and course of illness.

DSM-IV's classification of body dysmorphic disorder (BDD) is controversial. Whereas BDD is classified as a somatoform disorder, its delusional variant is classified as a psychotic disorder. However, the relationship between these BDD variants has received little investigation. In this study, we compared BDD's delusional and nondelusional variants in 191 subjects using reliable and valid measures that assessed a variety of domains. Subjects with delusional BDD were similar to those with nondelusional BDD in terms of most variables, including most demographic features, BDD characteristics, most measures of functional impairment and quality of life, comorbidity, and family history. Delusional and nondelusional subjects also had a similar probability of remitting from BDD over 1 year of prospective follow-up. However, delusional subjects had significantly lower educational attainment, were more likely to have attempted suicide, had poorer social functioning on several measures, were more likely to have drug abuse or dependence, were less likely to currently be receiving mental health treatment, and had more severe BDD symptoms. However, when controlling for BDD symptom severity, the two groups differed only in terms of educational attainment. These findings indicate that BDD's delusional and nondelusional forms have many more similarities than differences, although on several measures delusional subjects evidenced greater morbidity, which appeared accounted for by their more severe BDD symptoms. Thus, these findings offer some support for the hypothesis that these two BDD variants may constitute the same disorder. Additional studies are needed to examine this issue, which may have relevance for other disorders with both delusional and nondelusional variants in DSM.

Adolescent↗
PubMedDate not supplied

Body dysmorphic disorder in patients with acne.

There is growing evidence that the prevalence of body dysmorphic disorder (BDD) is significantly higher in specially selected populations as compared to the general population. The goal of the current study was to evaluate prevalence of BDD in Turkish patients with mild acne presenting to a dermatologist for treatment. This study was the first empirical investigation of BDD in acne patients in Turkey. One hundred fifty-nine outpatients diagnosed with acne who consulted to the dermatology clinic were included in the study. The diagnosis of BDD was based on DSM-IV criteria and the Structured Clinical Interview for DSM-IV (SCID-I). A study-specific questionnaire was administered to document and investigate the demographic and clinical characteristics of the cases. Fourteen (8.8%) patients were diagnosed with BDD. Three (21.4%) patients with acne and BDD also had concomitant psychiatric diagnoses. All of the patients were psychiatric management-naive, never received any psychological or physical treatments. BDD was a common psychiatric condition in acne cases. We suggest that dermatologists should routinely explore symptoms and screen such patients for BDD.

Acne Vulgaris↗
PubMedDate not supplied

[Liaison between body dysmorphic disorder and eating disorders].

This study presents the cases of anorexia nervosa which began with a body dysmorphic disorder lasting for at least 6 months. In some subjects (25%) there was comorbidity of 3 mental disorders: anancastic personality or obsessive-compulsive disorder + dysmorphophobia + anorexia nervosa or dysmorphophobia + anorexia nervosa + depressive disorder (dysthymia or major depression). The author considers the conception that in some cases dysmorphophobia and anorexia nervosa are a spectre of obsessive-compulsive disorder or affective disorders in adolescents.

Adolescent↗
PubMed2005

Clinical features of muscle dysmorphia among males with body dysmorphic disorder.

Muscle dysmorphia - a pathological preoccupation with muscularity - appears to be a form of body dysmorphic disorder (BDD) with a focus on muscularity. However, little is known about muscle dysmorphia in men with BDD, and no study has compared men with BDD who do and do not report muscle dysmorphia. To explore this issue, we reviewed the histories of 63 men with BDD; we compared those rated as having a history of muscle dysmorphia with those who had BDD but not muscle dysmorphia in several domains. The 14 men with muscle dysmorphia resembled the 49 comparison men in demographic features, BDD severity, delusionality, and number of non-muscle-related body parts of concern. However, those with muscle dysmorphia were more likely to have attempted suicide, had poorer quality of life, and had a higher frequency of any substance use disorder and anabolic steroid abuse. Thus, muscle dysmorphia was associated with greater psychopathology.

Journal Article↗
PubMedDate not supplied

Body dysmorphic disorder in psychiatric outpatients: recognition, prevalence, comorbidity, demographic, and clinical correlates.

The prevalence of Body Dysmorphic Disorder (BDD), based on structured and unstructured clinical interviews, was compared in two samples of psychiatric outpatients drawn from the same practice setting. In the first sample, 500 patients were diagnosed according to a routine, unstructured clinical interview. In the second sample, 500 subjects were diagnosed according to information obtained by the Structured Clinical Interview for DSM-IV (SCID). No patient was diagnosed with BDD in the clinical sample, whereas 16 (3.2%) patients were diagnosed with BDD in the SCID sample. Compared with patients without BDD, patients with BDD received significantly more current axis I diagnoses, and were more likely to be diagnosed with current obsessive-compulsive disorder (OCD) and social phobia. Both groups were diagnosed with major depression at similar rates. Patients with BDD, versus those without, tended to be sicker and more functionally impaired. It appears that BDD is an infrequent disorder in an outpatient setting, which is rarely recognized when clinicians conduct their routine diagnostic interview. Although it was not usually a patient's principal reason for seeking treatment, the majority of patients with BDD in this sample wanted their treatment to address these symptoms.

Adult↗
PubMedDate not supplied

Pharmacotherapy for body dysmorphic disorder: treatment received and illness severity.

BACKGROUND: Research on pharmacotherapy received by individuals with body dysmorphic disorder (BDD), a relatively common and impairing disorder, is very limited. METHODS: We examined past and current pharmacotherapy received by 151 individuals with BDD who were recruited from diverse sources. RESULTS: 72.9% of subjects had received psychotropic medication. The most common type ever received was an SRI (65.6%), followed by non-SRI antidepressants (41.1%) and benzodiazepines (27.2%). Subjects with greater lifetime impairment due to BDD were more likely to have received pharmacotherapy, and subjects with lifetime OCD or greater lifetime impairment due to BDD were more likely to have received an SRI specifically. Subjects revealed their BDD symptoms to only 41.0% of pharmacotherapists. Only 12.9% of SRI trials were considered optimal for BDD, and an additional 21.5% were considered minimally adequate. SRI trials that were considered optimal or at least minimally adequate for BDD were associated with greater improvement in BDD and less severe current BDD symptoms than non-optimal or inadequate SRI trials. CONCLUSIONS: A high proportion of individuals with BDD receive pharmacotherapy, primarily SRIs, although most SRI trials appear inadequate for BDD. SRI treatment that was considered adequate was associated with greater improvement in BDD and less severe BDD symptoms.

Adult↗
PubMed2005

Predictors of remission from body dysmorphic disorder: a prospective study.

In the first naturalistic, prospective study of the course of body dysmorphic disorder (BDD), we examined predictors of remission in 161 subjects over 1 year of follow-up. Data were obtained on clinical characteristics at the intake interview and weekly BDD symptom severity over 1 year using the Longitudinal Interval Follow-Up Evaluation. More severe BDD at intake, longer BDD duration, and the presence of a comorbid personality disorder predicted a lower likelihood of partial or full remission from BDD. BDD remission was not predicted by gender; race/ethnicity; socioeconomic status; being an adult versus an adolescent; age of BDD onset; delusionality of BDD symptoms; or the presence at intake of major depression, a substance use disorder, social phobia, obsessive compulsive disorder, or an eating disorder. Receipt of mental health treatment or nonmental health treatment (e.g., surgery, dermatologic treatment) during the follow-up year also did not predict remission from BDD.

Adult↗
PubMed2002

Pharmacologic treatment of body dysmorphic disorder: review of the evidence and a recommended treatment approach.

Research on effective pharmacotherapy for body dysmorphic disorder (BDD) has rapidly increased in recent years, with emerging data consistently indicating that serotonin reuptake inhibitors (SRIs) are often efficacious for this disorder. Although data are limited, it appears that higher SRI doses and longer treatment trials than those used for many other psychiatric disorders are often needed to treat BDD effectively. Approaches to treatment-resistant BDD have received little investigation, but available data indicate that switching to another SRI and several SRI-augmentation strategies may be helpful. This article reviews the empirical literature on BDD and offers a recommended approach to the pharmacotherapy of this distressing and often disabling disorder.

Journal Article↗
PubMed2006

Suicidality in body dysmorphic disorder: a prospective study.

OBJECTIVE: Cross-sectional/retrospective data have indicated that individuals with body dysmorphic disorder (BDD) have high rates of suicidal ideation and attempts. However, no study, to the authors' knowledge, has prospectively examined suicidality in BDD. METHOD: In the first prospective study of BDD's course, the authors examined suicidality in 185 subjects for up to 4 years. RESULTS: Suicidal ideation was reported by a mean of 57.8% of the subjects per year, and a mean of 2.6% attempted suicide per year. Two subjects (0.3% per year) completed suicide. CONCLUSIONS: Individuals with BDD have high rates of suicidal ideation and attempts. The completed suicide rate is preliminary but suggests that the rate of completed suicide in BDD is markedly high.

Adult↗
PubMed1996

An open study of buspirone augmentation of serotonin-reuptake inhibitors in body dysmorphic disorder.

Although preliminary data suggest that serotonin reuptake inhibitors (SRIs) may be effective in treating body dysmorphic disorder (BDD), a substantial percentage of patients have no response or respond only partially to SRIs. The efficacy of buspirone augmentation of SRIs in BDD was therefore evaluated in an open fashion. Thirteen patients with DSM-IV BDD who had not responded or had responded only partially to an SRI had buspirone added to the SRI. Six of these subjects (46%) improved. Three who decreased or discontinued buspirone experienced an increase in symptom severity. BDD symptoms again improved in the 1 subject who resumed the previous dose. Side effects were minimal and well tolerated in all but 1 subject. These data, while preliminary, suggest that buspirone augmentation of SRIs may be useful for BDD and warrant further investigation in a controlled trial.

Adult↗