The relationship of body dysmorphic disorder and eating disorders to obsessive-compulsive disorder

Brown Medical School, Providence, RI, USA.
CNS spectrums (Impact Factor: 2.71). 06/2007; 12(5):347-58.
Source: PubMed


Body dysmorphic disorder (BDD) and eating disorders are body image disorders that have long been hypothesized to be related to obsessive-compulsive disorder (OCD). Available data suggest that BDD and eating disorders are often comorbid with OCD. Data from a variety of domains suggest that both BDD and eating disorders have many similarities with OCD and seem related to OCD. However, these disorders also differ from OCD in some ways. Additional research is needed on the relationship of BDD and eating disorders to OCD, including studies that directly compare them to OCD in a variety of domains, including phenomenology, family history, neurobiology, and etiology.

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Available from: Walter H Kaye, Dec 14, 2014
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    • "Moreover, BDD is often considered to be on the obsessive-compulsive disorder (OCD) spectrum, due to similar phenomenology, demographics, heredity, course of illness, and response to treatment (Hollander and Wong, 1995; Phillips et al., 2007). (Of note, AN also has some features suggestive of overlap with OCD, including obsessive thoughts and ritualized eating behaviors , high comorbidity of OCD, and a high proportion of first degree relatives with OCD (Phillips et al., 2007).) Since distorted perception of appearance is a key feature of both AN and BDD, examining visual processing as a phenotype may provide a level of understanding about the relationship between these two disorders, and about the neurobiology behind this phenomenon , which is less likely to be captured by examining individual categorical diagnoses (Insel and Cuthbert, 2009). "
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    ABSTRACT: Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one's physical appearance. In AN, individuals believe that they are overweight, perceive their body as "fat," and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD.
    Journal of Psychiatric Research 06/2013; 47(10). DOI:10.1016/j.jpsychires.2013.06.003 · 3.96 Impact Factor
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    • "Patients with BDD tend to have more self-focused obsessional beliefs, whereas people with OCD are more often concerned about moral repugnance and/or potential harm to others (Phillips & Kaye, 2007). In addition, BDD beliefs are also more often characterized by poor insight and classified as delusional (Phillips et al., 2007). Repetitive behaviors in BDD are less likely "
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    ABSTRACT: Obsessive-compulsive (OC)-spectrum conditions consist of neurological-motoric conditions, impulse-control disorders, and disorders associated with bodily preoccupation. This article is a review of some understudied OC-spectrum conditions, with particular focus on phenomenology and overlap with obsessive-compulsive disorder, etiology, treatment outcome, treatment refractory issues, and new developments in treatment research. The focus will be on representative disorders from each related area, namely, Tourette's syndrome, trichotillomania, skin-picking, and body dysmorphic disorder. Similarities among the disorders and areas in need of more research are discussed.
    Bulletin of the Menninger Clinic 06/2010; 74(2):141-66. DOI:10.1521/bumc.2010.74.2.141 · 0.72 Impact Factor
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    ABSTRACT: Knowledge concerning the classification of mental disorders progressed substantially with the use of DSM III-IV and IDCD 10 because it was based on observed data, with precise definitions. These classifications a priori avoided to generate definitions related to etiology or treatment response. They are based on a categorical approach where diagnostic entities share common phenomenological features. Modifications proposed or discussed are related to the weak validity of the classification strategy described above. (a) Disorders are supposed to be independent but the current coexistence of two or more disorders is the rule; (b) They also are supposed to have stability, however anxiety disorders most of the time precede major depression. For GAD age at onset, family history, biology and symptomatology are close to those of depression. As a consequence broader entities such as depression-GAD spectrum, panic-phobias spectrum and OCD spectrum including eating disorders and pathological gambling are taken into consideration; (c) Diagnostic categories use thresholds to delimitate a border with normals. This creates "subthreshold" conditions. The relevance of such conditions is well documented. Measuring the presence and severity of different dimensions, independent from a threshold, will improve the relevance of the description of patients pathology. In addition, this dimensional approach will improve the problems posed by the mutually exclusive diagnoses (depression and GAD, schizophrenia and depression); (d) Some disorders are based on the coexistence of different dimensions. Patients may present only one set of symptoms and have different characteristics, evolution and response to treatment. An example would be negative symptoms in Schizophrenia; (e) Because no etiological model is available and most measures are subjective, objective measures (cognitive, biological) and genetics progresses created important hopes. None of these measures is pathognomonic and most appear to be related to risk factors especially at certain periods when associated with environmental events. One of the major aims for a classification of patients is to identify groups to whom a best possible therapeutic strategy can be proposed. Drugs may improve fear extinction while the genetic and/or acquired avoidance may be called phobia. The basic mechanism and or the corresponding phenotype should appear in the classification. Progresses in early identification of disturbances by taking into account all the information available (prodromal symptoms, cognitive, biological, imaging, genetic, family information) are crucial for the future therapeutic strategy: prevention.
    European Archives of Psychiatry and Clinical Neuroscience 04/2008; 258 Suppl 1(S1):6-11. DOI:10.1007/s00406-007-1003-0 · 3.53 Impact Factor
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