Body dysmorphic disorder in patients with obsessive-compulsive disorder: Prevalence and clinical correlates

Projeto Transtornos do Espectro Obsessivo-Compulsivo (PROTOC, Obsessive-Compulsive Spectrum Disorders Project), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil.
Depression and Anxiety (Impact Factor: 4.29). 11/2012; 29(11). DOI: 10.1002/da.21980
Source: PubMed

ABSTRACT The prevalence, sociodemographic aspects, and clinical features of body dysmorphic disorder (BDD) in patients with obsessive–compulsive disorder (OCD) have been previously addressed in primarily relatively small samples.
We performed a cross-sectional demographic and clinical assessment of 901 OCD patients participating in the Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders. We used the Structured Clinical Interview for DSM-IV Axis I Disorders; Yale-Brown Obsessive–Compulsive Scale; Dimensional Yale-Brown Obsessive–Compulsive Scale (DY-BOCS); Brown Assessment of Beliefs Scale; Clinical Global Impression Scale; and Beck Depression and Anxiety Inventories.
The lifetime prevalence of BDD was 12.1%. The individuals with comorbid BDD (OCD-BDD; n = 109) were younger than were those without it. In addition, the proportions of single and unemployed patients were greater in the OCD-BDD group. This group of patients also showed higher rates of suicidal behaviors; mood, anxiety, and eating disorders; hypochondriasis; skin picking; Tourette syndrome; and symptoms of the sexual/religious, aggressive, and miscellaneous dimensions. Furthermore, OCD-BDD patients had an earlier onset of OC symptoms; greater severity of OCD, depression, and anxiety symptoms; and poorer insight. After logistic regression, the following features were associated with OCD-BDD: current age; age at OCD onset; severity of the miscellaneous DY-BOCS dimension; severity of depressive symptoms; and comorbid social phobia, dysthymia, anorexia nervosa, bulimia nervosa, and skin picking.
Because OCD patients might not inform clinicians about concerns regarding their appearance, it is essential to investigate symptoms of BDD, especially in young patients with early onset and comorbid social anxiety, chronic depression, skin picking, or eating disorders.

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Available from: Euripedes C Miguel, Aug 30, 2015
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    • "These disorders generally require long-term treatment and share serotonin reuptake inhibitors (SRI) and cognitive behavior therapy (CBT) as their first-line treatment options (Bandelow et al., 2012; Neziroglu and Khemlani-Patel, 2002; Phillips and Hollander, 2008). The combination of OCD and BDD (OCD-BDD) is associated with poorer insight of OCD symptoms (Costa et al., 2012; Eisen et al., 2004; Nakata et al., 2007; Phillips et al., 2012), higher frequency of suicidal behaviors (Costa et al., 2012; Phillips et al., 2007), higher prevalence of hoarding symptoms (Costa et al., 2012; Nakata et al., 2007) and a higher frequency of specific psychiatric comorbidities (Costa et al., 2012; Diniz et al., 2006; Frare et al., 2004; Nakata et al., 2007; Phillips et al., 1998; Veale et al., 1996) in comparison with OCD without comorbid BDD (OCDnon-BDD ). Most of these characteristics were associated with worse prognosis, in previous studies (Belotto-Silva et al., 2012; Catapano et al., 2010; Erzegovesi et al., 2001; Mataix-Cols et al., 1999; Kishore et al., 2004; Shetti et al., 2005); nevertheless, in the only study that systematically investigated the impact of BDD on OCD treatment response, there were similar response patterns observed in OCD patients with and without comorbid BDD (Stewart et al., 2008). "
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