Prevalence and Clinical Features of Body Dysmorphic Disorder in Adolescent and Adult Psychiatric Inpatients
J Clin Psychiatry 2001;62(7):517-522
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Background: The rate of body dysmorphic disorder
(BDD) in inpatient psychiatric settings and the nature of the
presenting complaints are unknown. Because of the shame and
humiliation that BDD patients suffer, we hypothesized that,
unless specifically screened for at the time of admission, BDD
would be underdiagnosed in psychiatric inpatients.
Method: 101 consecutive adult patients and 21
consecutive adolescent patients presenting for psychiatric
inpatient admission to a university teaching hospital
participated in the study. Subjects completed the Body Dysmorphic
Disorder Questionnaire, a brief self-report measure that screens
for BDD, and a follow-up interview was conducted using a reliable
clinician-administered semistructured diagnostic instrument for
DSM-IV BDD. Data concerning current diagnoses, number of
hospitalizations, number of suicide attempts, and current level
of functioning were also obtained.
Results: Sixteen (13.1%) of the 122 subjects
were diagnosed with BDD. None of the subjects with BDD had been
diagnosed with BDD by their treating physician during
hospitalization. All 16 subjects reported that they would not
raise the issue with their physician unless specifically asked
due to feelings of shame.
Conclusion: These preliminary results suggest
that BDD, an underrecognized and often severe psychiatric
disorder, may be relatively common in the psychiatric inpatient
setting. It is important that clinicians specifically inquire
about BDD because patients will not voluntarily raise these
concerns. The comorbidity of this disorder with other psychiatric
illnesses may have treatment implications.