Age at onset and clinical correlates in body dysmorphic disorder

This chapter discusses muscle dysmorphia (“bigorexia”), including its historical context, diagnostic features, epidemiology, associated psychiatric and medical conditions, and potential treatment approaches. Muscle dysmorphia is a specifier (subtype) of body dysmorphic disorder (BDD) characterized by pathologic preoccupation with muscularity and fear or anxiety about not being big or muscular enough, despite having an objectively normal or muscular body—or even a very muscular build. It is most often seen in males; average age at onset is before the end of the second decade. This preoccupation with body image often compromises social and occupational functioning, in part because of compulsive and meticulous exercise and dietary regimens. Individuals may avoid bodily exposure because of shame associated with perceived small body build. There is significant comorbid medical, social, and psychological disease burden, including disordered eating, other forms of BDD, anxiety, and substance use disorders (often steroid abuse). Treatment is challenging, as many patients do not present to a clinician.

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Body Dysmorphic Disorder

The British Journal of Psychiatry ◽

10.1192/bjp.169.2.196 ◽

1996 ◽

Vol 169 (2) ◽

pp. 196-201 ◽

Cited By ~ 354

Author(s):

David Veale ◽

Ann Boocock ◽

Kevin Gournay ◽

Windy Dryden ◽

Fozia Shah ◽

...

Keyword(s):

Body Dysmorphic Disorder ◽

Suicide Attempts ◽

Age At Onset ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Primary Disorder ◽

The Usa ◽

Axis I ◽

High Degree

BackgroundBody dysmorphic disorder (BDD) consists of a preoccupation with an ‘imagined’ defect in appearance which causes significant distress or impairment in functioning. There has been little previous research into BDD. This study replicates a survey from the USA in a UK population and evaluates specific measures of BDD.MethodCross-sectional interview survey of 50 patients who satisfied DSM–IV criteria for BDD as their primary disorder.ResultsThe average age at onset was late adolescence and a large proportion of patients were either single or divorced. Three-quarters of the sample were female. There was a high degree of comorbidity with the most common additional Axis I diagnosis being either a mood disorder (26%), social phobia (16%) or obsessive–compulsive disorder (6%). Twenty-four per cent had made a suicide attempt in the past. Personality disorders were present in 72% of patients, the most common being paranoid, avoidant and obsessive–compulsive.ConclusionsBDD patients had a high associated comorbidity and previous suicide attempts. BDD is a chronic handicapping disorder and patients are not being adequately identified or treated by health professionals.

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Clinical Correlates and Familial Aggregation of Age at Onset in Bipolar Disorder

American Journal of Psychiatry ◽

10.1176/appi.ajp.163.2.240 ◽

2006 ◽

Vol 163 (2) ◽

pp. 240-246 ◽

Cited By ~ 117

Author(s):

Ping-I Lin ◽

Melvin G. McInnis ◽

James B. Potash ◽

Virginia Willour ◽

Dean F. MacKinnon ◽

...

Keyword(s):

Bipolar Disorder ◽

Familial Aggregation ◽

Age At Onset ◽

Clinical Correlates

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Childhood, adolescent and adult age at onset and related clinical correlates in obsessive–compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

International Journal of Psychiatry in Clinical Practice ◽

10.1080/13651501.2016.1207087 ◽

2016 ◽

Vol 20 (4) ◽

pp. 210-217 ◽

Cited By ~ 24

Author(s):

Bernardo Dell’Osso ◽

Beatrice Benatti ◽

Eric Hollander ◽

Naomi Fineberg ◽

Dan J. Stein ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Age At Onset ◽

Obsessive Compulsive ◽

Adult Age ◽

Compulsive Disorder ◽

Clinical Correlates ◽

International College ◽

Spectrum Disorders

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Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20197919 ◽

2019 ◽

Vol 94 (4) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Adeolu Oladayo Akinboro ◽

Adegoke Oloruntoba Adelufosi ◽

Olaniyi Onayemi ◽

Stephen O Asaolu

Keyword(s):

Body Dysmorphic Disorder ◽

Clinical Correlates ◽

Dermatology Clinic

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Prevalence, Sociodemographic, and Clinical Correlates of Older Chinese Patients With Deficit Schizophrenia

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988719870321 ◽

2019 ◽

Vol 32 (6) ◽

pp. 298-303 ◽

Cited By ~ 2

Author(s):

Junjun Liu ◽

Jinfeng He ◽

Min Cheng ◽

Hui Cao ◽

Xiangrong Zhang

Keyword(s):

Multiple Logistic Regression Analysis ◽

Age At Onset ◽

Community Dwelling ◽

Chinese Patients ◽

Current Smoking ◽

Deficit Syndrome ◽

Clinical Correlates ◽

Deficit Schizophrenia ◽

Male Sex ◽

Older Chinese

Objective: No study has investigated the frequency and risk factors for deficit schizophrenia (DS) in Chinese Han population. We investigated the prevalence of DS among community-dwelling older Chinese patients with schizophrenia and examined the sociodemographic and clinical correlates of DS in this population. Methods: A total of 326 community-dwelling older patients with schizophrenia were recruited in this cross-sectional study. Deficit schizophrenia was confirmed using the Chinese version of the Schedule for the Deficit Syndrome. Data pertaining to sociodemographic and clinical characteristics were collected. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Results: The prevalence of DS in the study population was 26.7% (31.2% among male patients and 21.6% among female patients with schizophrenia). Patients with DS had significantly higher current smoking rate, hospitalizations, PANSS negative score, PANSS total score, and had earlier age at onset than patients with non-deficit schizophrenia (N-DS). The N-DS patients had higher PANSS positive scores and a greater proportion of married patients. Multiple logistic regression analysis indicated that negative PANSS score (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.04-1.16, P < .001), male sex (OR = 1.71, 95% CI = 1.53-1.91, P = .037), age at onset (OR = 0.88, 95% CI = 0.82-0.94, P = .035), and current smoking (OR = 1.37, 95% CI = 1.15-1.63, P = .041) were independently associated with DS. Conclusion: Deficit schizophrenia is relatively common among older community-dwelling Chinese patients with schizophrenia. High negative symptom scores, male sex, early onset, and smoking were independent correlates for DS.

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