I am currently working on a class presentation on Body Dysmorphic Disorder for my psychopathology class.
I will post the final powerpoint when it is done (which wont be until march or april) but here are some interesting stats and information I found in my initial search this afternoon.
Phillips, Katharine A (1997) Gender differences in body dysmorphic disorder. Journal of nervous and mental disease 185(9) 570-577
**Women more likely (than man) to be preoccupied with hips and weight, pick their skin and camouflage with makeup, and have comorbid BN.
** Men are more likely to be preoccupied with body build, genitals, and hair thinning, use hat for camouflage, be unmarried, and have alcohol abuse or dependence.
**Suggests that cultural norms and values may influence the content of BDD symptom
Phillips, Katharine A (july 2006). The presentation of body dysmorphic disorder in medical settings. Prim psychiatry, 13(7) 51-59. doi: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1712667/
- Commonly misdiagnosed as major depressive disorder, social anxiety disorder, agoraphobia, ocd, trichotillomania, schizophrenia
- Common is patients with substance abuse and eating disorders
- Most common disorders are MDD (76: lifetime prevalence) social anxiety disorder (37) and OCD (32%) Substance use (48%)
- Many will seek nonpsychiatric physicians such as dermatologists and surgeons seeking cosmetic solutions
- Have unusually high rates of suicidal ideation, suicide attempts and completed suicide
- 78% experienced suicidal ideations
- 69% considered suicide as a direct result of BDD
- 24-28% have attempted suicide
- Gender ration ranges from 1:1 to 3:2 (female: male)
- Usually begins during early adolescence however treatment seeking is delayed an average of 11 years after onset
- Prevalence in community and nonclinical student samples range from 0.7% to 13%
- On average, excessively preoccupied with non-existent of minimal appearance flaws. Skin is the most common area of concern (acne or scarring). 2nd most common: hair (hair loss, thinning, balding or excessive facial/body hair).
- Tend to camouflaging with things as body position, clothing makeup, hat
- Skin picking is found in approximately 1/3 of BDD patient
Case Report: A Young Woman with Body Dysmorphic Disorder
Ms. A was an attractive 28-year-old Hispanic teacher who presented with a chief complaint of “I am obsessed with my appearance, and my plastic surgeon has been trying to get me to see a psychiatrist for 4 years.” Ms. A had undergone 15 cosmetic surgeries, which did not diminish her appearance concerns. These included rhinoplasties, liposuction, a chin implant, collagen implants, and other procedures, some of which were repeated because the patient was dissatisfied with the outcome of previous procedures. Because she thought that her appearance defects were real, she had been reluctant to see a psychiatrist. She believed that her appearance problems would be fixed by “just one more surgery.” However, Ms. A acknowledged that psychiatric treatment might be helpful for the anxiety and depression that her appearance concerns caused. Ms. A said she disliked everything about how she looked, including her supposedly scarred and discolored skin, flat hair, big and bumpy nose, receding chin, thin lips, high forehead, flabby thighs, fat stomach, and stumpy legs. She obsessed about these perceived flaws for 8 hours/day. Because she thought she looked so ugly, Ms. A did not date, avoided many social situations, and often missed work. She also drank excessively to diminish her distress and quell her anxiety in social situations. She was unable to see friends or participate in any social event without first becoming intoxicated, as she felt that this helped her focus less on her appearance flaws and feel more comfortable with the scrutiny that she perceived from other people.
Case Report: A Young Man With Body Dysmorphic Disorder
Mr. B, a 23-year-old single white male, was obsessed with his skin. Throughout the day he thought about how his perceived facial acne and scars looked hideous. Because he felt so anxious and depressed over how he looked and thought he was too ugly for other people to see him, he dropped out of college, moved back into his parents’ house, and stayed in his bedroom. He saw no friends and did not leave the house. He felt too anxious about his skin to even eat meals with his family. As a result of his appearance concerns, Mr. B felt severely depressed and considered suicide. Topical and oral agents prescribed by a dermatologist did not diminish his appearance concerns. However, after 12 weeks of treatment with escitalopram, reaching a total dose of 30 mg/day, all of Mr. B’s symptoms were in complete remission. For the first time in years, he ate meals with his family, left the house, ran errands, saw friends, and made plans to return to school.