Suicidal Ideation and Suicide Attempts in Body Dysmorphic Disorder
J Clin Psychiatry 2005;66(6):717-725
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Because suicidality in body
dysmorphic disorder (BDD) has received little investigation, this
study examined rates, correlates, predictors, and other aspects
of suicidal ideation and suicide attempts in this disorder.
Method: From January 2001 to June 2003, 200
subjects with DSM-IV BDD recruited from diverse sources were
assessed with standard measures.
Results: Subjects had high rates of lifetime
suicidal ideation (78.0%) and suicide attempts (27.5%). Body
dysmorphic disorder was the primary reason for suicidal ideation
in 70.5% of those with a history of ideation and nearly half of
subjects with a past attempt. Suicidal subjects often did not
reveal their BDD symptoms to their clinician. In univariate
analyses, both suicidal ideation and suicide attempts were
associated with lifetime functional impairment due to BDD
(p < .001), current functional impairment (p < .001 to < .05),
lifetime bipolar disorder (p < .05), any personality disorder
(p < .05 to .001), and comorbid borderline personality disorder
(p < .01 to < .001). A history of suicidal ideation (but not
suicide attempts) was additionally associated with comorbid
lifetime major depression (p = .001). A history of suicide attempts
(but not suicidal ideation) was additionally associated with
delusional appearance beliefs (p = .01) and lifetime posttraumatic
stress disorder (PTSD), an eating disorder, or a substance use
disorder (p < .001 to < .05). In logistic regression analyses,
suicidal ideation was significantly predicted by comorbid major
depression (p = .010) and greater lifetime impairment due to BDD
(p = .003); suicide attempts were significantly predicted by PTSD
(p = .011), a substance use disorder (p = .011), and greater lifetime
impairment due to BDD (p = .005).
Conclusion: Individuals with BDD have high rates
of suicidal ideation and suicide attempts. Lifetime impairment
due to BDD and certain comorbid disorders are associated with