A Retrospective Review of Clinical Characteristics and Treatment Response in Body Dysmorphic Disorder Versus Obsessive-Compulsive Disorder
J Clin Psychiatry 2001;62(1):67-72
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Although body dysmorphic disorder
(BDD) has many features in common with obsessive-compulsive
disorder (OCD) and is frequently comorbid with OCD, few studies
have directly compared the 2 disorders. Although BDD and OCD
respond to similar medications and cognitive-behavioral therapy
(CBT), their response to treatment has never been directly
Method: We studied 107 consecutive patients with
DSM-III-R OCD (N = 96) or BDD (N = 11) treated openly for 6 weeks
with intensive CBT, medication, and psychosocial rehabilitation,
in a specialized partial hospitalization program for severely ill
OCD patients. All patients were assessed, before and after
treatment, with the Yale-Brown Obsessive Compulsive Scale
(Y-BOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton
Rating Scale for Anxiety (HAM-A), and Global Assessment Scale
(GAS). Retrospectively, we compared the clinical characteristics,
symptom severity, and response to treatment of BDD patients with
those of OCD patients.
Results: BDD patients and OCD patients had
similar sex ratio, age, treatment duration, prevalence of
comorbid major depression, and pretreatment Y-BOCS and GAS
scores. BDD patients had significantly higher pretreatment HAM-D
and HAM-A scores. The proportions of patients treated with
serotonin reuptake inhibitors and antipsychotics did not differ
between groups. Both groups improved with treatment, with
significant (p < .001) changes in Y-BOCS, HAM-D, HAM-A, and
GAS scores. Change in Y-BOCS did not differ between groups, but
changes in HAM-D and HAM-A were significantly greater in BDD
patients than in OCD patients.
Conclusion: While BDD may be associated with
greater severity of depressive and anxiety symptoms than OCD,
this study suggests that BDD may respond to intensive, multimodal