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

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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.
    Full-text · Article · Jun 2013 · Journal of Psychiatric Research
    • "Body dysmorphic disorder (BDD) is an often severe mental disorder that consists of distressing or impairing preoccupations with nonexistent or slight defects in appearance. BDD appears to be closely related to several anxiety disorders, particularly obsessivecompulsive disorder (OCD) and social phobia (SP) (Phillips et al., 1998; Frare et al., 2004; Phillips et al., 2007; Fang and Hofmann, 2010). Much attention has been paid to similarities between BDD and OCD (Phillips et al., 1998; Frare et al., 2004; Phillips and Stout, 2006; Phillips and Kaye, 2007; Phillips et al., 2007; Stewart et al., 2008). "
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    ABSTRACT: Body dysmorphic disorder (BDD) shares many characteristics with social phobia (SP), including high levels of social anxiety and avoidance, but to our knowledge no studies have directly compared these disorders’ demographic and clinical features. Demographic and clinical features were compared in individuals with BDD (n=172), SP (n=644), and comorbid BDD/SP (n=125). SP participants had a significantly earlier age of onset and lower educational attainment than BDD participants. BDD participants were significantly less likely to ever be married than SP participants, had a greater likelihood of ever being psychiatrically hospitalized, and had significantly lower mean GAF scores than SP participants. The two groups had different comorbidity patterns, which included a greater likelihood for BDD participants to have comorbid obsessive-compulsive disorder (OCD) or an eating disorder, vs. a greater likelihood for SP participants to have a comorbid non-OCD anxiety disorder. The comorbid BDD/SP group had significantly greater morbidity across several domains than the SP only group, but not the BDD only group. In summary, although BDD and SP were similar across many demographic and clinical features, they had important differences. Future studies are needed to confirm these findings and address similarities and differences between these disorders across a broader range of variables.
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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.
    Full-text · Article · Jun 2010 · Bulletin of the Menninger Clinic
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