Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features

Conrado, Luciana Archetti; Hounie, Ana Gabriela; Diniz, Juliana Belo; Fossaluza, Victor; Torres, Albina Rodrigues; Miguel, Euripedes Constantino; Rivitti, Evandro Ararigboia

doi:10.1016/j.jaad.2009.09.017

« Previous Next »Journal of the American Academy of Dermatology
Volume 63, Issue 2 , Pages 235-243, August 2010

Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features

Luciana Archetti Conrado, MD, PhD
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
- Reprint requests: Luciana Archetti Conrado, MD, PhD, Clinica de Dermatologia Luciana Conrado, Rua Caconde, 96/104. CEP: 01425-010. São Paulo/SP Brazil.
Ana Gabriela Hounie, MD, PhD
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
Juliana Belo Diniz, MD, PhD
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
Victor Fossaluza, MS
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
Albina Rodrigues Torres, MD, PhD
- Department of Neurology, Psychology, and Psychiatry of Botucatu Medical School–São Paulo State, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), São Paulo, Brazil
Euripedes Constantino Miguel, MD, PhD
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
Evandro Ararigboia Rivitti, MD, PhD
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil

Accepted 18 September 2009. published online 21 June 2010.

Background

An impairing preoccupation with a nonexistent or slight defect in appearance is the core symptom of body dysmorphic disorder (BDD), a psychiatric condition common in dermatology settings.

Objective

We sought to determine the prevalence of BDD in dermatologic patients, comparing general and cosmetic settings, and describing some demographic and clinical characteristics.

Methods

In all, 300 patients were consecutively assessed. Screening and diagnoses were performed with validated instruments plus a best estimate diagnosis procedure. The final sample comprised 150 patients in the cosmetic group, 150 patients in the general dermatology group, and 50 control subjects. Standard statistical analyses were performed (χ², nonparametric tests, logistic regression).

Results

The current prevalence was higher in the cosmetic group (14.0%) compared with general (6.7%) and control (2.0%) groups. No patient had a previous diagnosis. Frequently the reason for seeking dermatologic treatment was not the main BDD preoccupation. Patients with BDD from the cosmetic group were in general unsatisfied with the results of dermatologic treatments.

Limitations

Cross-sectional study conducted in a university hospital is a limitation. It is uncertain if the findings can be generalized. Retrospective data regarding previous treatments are not free from bias.

Conclusions

BDD is relatively common in a dermatologic setting, especially among patients seeking cosmetic treatments. These patients have some different features compared with general dermatology patients. Dermatologists should be aware of the clinical characteristics of BDD to identify and refer these patients to mental health professionals.

Key words: body dysmorphic disorder, body image, body image dissatisfaction, cosmetic procedures, cosmetic treatments, dermatologic symptoms