BODY DYSMORPHIC DISORDER IN PATIENTS WITH OBSESSIVE–COMPULSIVE DISORDER: PREVALENCE AND CLINICAL CORRELATES

Authors

  • Daniel Lucas Conceição Costa M.D.,

    Corresponding author
    • 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
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  • Melissa Chagas Assunção M.D.,

    1. Departament of Neurology Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP, Brazil
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  • Ygor Arzeno Ferrão M.D., Ph.D.,

    1. Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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  • Luciana Archetti Conrado M.D., Ph.D.,

    1. Department of Dermatology, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
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  • Christina Hajaj Gonzalez M.D., Ph.D.,

    1. Department of Psychiatry and Psychology, School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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  • Leonardo Franklin Fontenelle M.D., Ph.D.,

    1. The Anxiety and Depression Research Program, Institute of Psychiatry, School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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  • Victor Fossaluza Ph.D.,

    1. Department of Statistics, Institute of Mathematics and Statistics, Universidade de São Paulo, São Paulo, Brazil
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  • Eurípedes Constantino Miguel M.D. Ph.D.,

    1. 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
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  • Albina Rodrigues Torres M.D., Ph.D.,

    1. Departament of Neurology Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Botucatu, SP, Brazil
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  • Roseli Gedanke Shavitt M.D., Ph.D.

    1. 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
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Correspondence to: Daniel Lucas Conceição Costa, Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, 01060-970 São Paulo, SP, Brazil. E-mail: danielcosta228@yahoo.com.br

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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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