Obsessive–compulsive disorder and body dysmorphic disorder: a comparison of clinical features

AbstractBody dysmorphic disorder (BDD) is currently classified as a somatoform disorder in DSM-IV, but has been long noted to have some important similarities with obsessive—compulsive disorder (OCD). In addition, BDD and OCD have been often reported to be comorbid with each other. In the present study, we compared demographic characteristics, clinical features and psychiatric comorbidity in patients with OCD, BDD or comorbid BDD—OCD (34 subjects with BDD, 79 with OCD and 24 with BDD—OCD). We also compared the pattern of body dysmorphic concerns and associated behaviors in BDD patients with or without OCD comorbidity. In our sample, BDD and OCD groups showed similar sex ratio. Both groups with BDD and BDD—OCD were significantly younger, and experienced the onset of their disorder at a significantly younger age than subjects with OCD. The two BDD groups were also less likely to be married, and more likely to be unemployed and to have achieved lower level degree, than OCD subjects even when controlling for age. The three groups were significantly different in the presence of comorbid bulimia, alcohol-related and substance-use disorders, BDD—OCD patients showing the highest rate and OCD the lowest. BDD—OCD reported more comorbid bipolar II disorder and social phobia than in the other two groups, while generalized anxiety disorder was observed more frequently in OCD patients. Patients with BDD and BDD—OCD were similar as regards the presence of repetitive BDD-related behaviors, such as mirror-checking or camouflaging. Both groups also did show a similar pattern of distribution as regards the localization of the supposed physical defects in specific areas of the body. The only significant difference concerned the localization in the face, that was more frequent in the BDD group. Our results do not contradict the proposed possible conceptualization of BDD as an OCD spectrum disorder. However, BDD does not appear to be a simple clinical variant of OCD and it seems to be also related to social phobia, mood, eating and impulse control disorders. The co-presence of BDD and OCD features appears to possibly individuate a particularly severe form of the syndrome, with a greater load of psychopathology and functional impairment and a more frequent occurrence of other comorbid mental disorders.

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Computerized Perceptual Analysis of Patients with Body Dysmorphic Disorder: A Pilot Study

CNS Spectrums ◽

10.1017/s1092852900017958 ◽

2002 ◽

Vol 7 (6) ◽

pp. 444-446 ◽

Cited By ~ 27

Author(s):

José A. Yaryura-Tobias ◽

Fugen Neziroglu ◽

Robert Chang ◽

Sean Lee ◽

Anthony Pinto ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Body Dysmorphic Disorder ◽

The Body ◽

Control Group ◽

Facial Features ◽

Body Perception ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Preliminary Study ◽

Made In

ABSTRACTMany factors influence the development of body image, one of which is the perception we have of our body. Perception can refer to actual visual input or the interpretation of vision; in other words, cognitive appraisal. The goal of this preliminary study is to determine if three groups (body dysmorphic disorder, obsessive-compulsive disorder, and a non-psychiatric control group) differed in the perception of their faces. Thirty individuals, 10 in each group, were asked to make changes to a computerized image of their face. In addition, affective and perceptual tests were administered. The groups did not differ on affective and perceptual organizational measures, although the obsessive-compulsive disorder group reported a higher level of anxiety than the body dysmorphic disorder group. Imaging software showed that facial features were modified by patients with body dysmorphic disorder and obsessive-compulsive disorder in about 50% of cases. No modifications were made in the control group. Future studies need to investigate the possible causes of these differences.

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Body Dysmorphic Disorder Insights in an Inpatient Psychiatric Setting

Case Reports in Psychiatry ◽

10.1155/2021/6636124 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Zachary A. Koenig ◽

Sarah Callaham ◽

Brittany Waltz ◽

Julie Bosley ◽

Raja Mogallapu ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Obsessive Compulsive Disorder ◽

Social Anxiety Disorder ◽

Body Dysmorphic Disorder ◽

The Body ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Psychiatric Setting ◽

Significant Impairment

Body dysmorphic disorder is a chronic disorder involving imagined or partial appearance defects that lead to significant impairment in everyday life. It is quite prevalent but remains a clinically underdiagnosed psychiatric condition especially in the inpatient psychiatric setting. Onset of body dysmorphic disorder typically begins in adolescence with subclinical symptoms. Over time, symptoms progress to patients meeting the full Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Severe cases of the body dysmorphic disorder are often camouflaged by concurrent diseases like major depressive disorder, obsessive-compulsive disorder, substance use disorder, and social anxiety disorder. Further, compounding the complexity of body dysmorphic disorder is a treatment of patients who present with coinciding suicidal ideations. Here, we present a unique case of a 40-year-old female admitted to an inpatient psychiatric unit for treatment of ongoing depression and suicidal symptoms. Early on in her inpatient course, she had symptoms of obsessive-compulsive disorder, social anxiety disorder, and alcohol use disorder. The constellation of symptoms prompted evaluation for body dysmorphic disorder and subsequent targeted treatment. This case report highlights the complexities associated with diagnosing body dysmorphic disorder, the importance of considering it a branch point for other psychiatric conditions, and the treatment for patients who present with coinciding suicidal behavior.

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Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive–compulsive disorder, and social phobia

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2005.10.001 ◽

2006 ◽

Vol 40 (4) ◽

pp. 360-369 ◽

Cited By ~ 32

Author(s):

K PHILLIPS ◽

R STOUT

Keyword(s):

Major Depression ◽

Social Phobia ◽

Obsessive Compulsive Disorder ◽

Body Dysmorphic Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Longitudinal Course

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Comparison of Treatment Response before and after Antiobsessivae Therapy among Psychiatric Patients with Obsessive Compulsive Disorder

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i2.40042 ◽

2022 ◽

Vol 19 (1) ◽

pp. 5-8

Author(s):

Mohan Belbase ◽

Jyoti Adhikari

Keyword(s):

Treatment Response ◽

Obsessive Compulsive Disorder ◽

Psychiatric Patients ◽

Statistical Significance ◽

Severe Form ◽

Age Group ◽

Obsessive Compulsive ◽

Male And Female ◽

Compulsive Disorder ◽

Significant Difference

Introduction: Obsessive compulsive disorder is a common, chronic and disabling disorder marked by obsessions and/or compulsions. This study tries to find the demographic profiles, severity and response of antiobsessive drugs in young and adult patients with obsessive compulsive disorder. Aims: To study the socio-demographic profile, severity and treatment response to commonly used antiobsessive medications in male and female, and young and adults. Methods: This is a hospital based experimental study done in patients attending to psychiatry out-patient department over one year from February 2020 to January 2021. Diagnosis of obsessive compulsive disorder was made based on International Classification of Disease- 10 criteria for research. Yale-Brown obsessive compulsive scale check list (adult and children) was applied in those patients and recorded accordingly on baseline (week 0) and patients were treated with specific serotonin reuptake inhibitors or tricyclic antidepressants in therapeutic doses for 6 weeks. On follow up at week 6, they were again reassessed and the scores were recorded and analyzed. Results: Among the total study subject (N-52), 26(50 %) were male and 26(50 %) were females. Patients in age bracket 20-29 is the most common age group representing 18(34.6 %). Mean age of patients is 30.36±11.93 years (28.65±9.80 in male and 32.04±13.73 in female). Severe form of obsessive compulsive disorder was the most common type that represent 33(63.5%) followed by moderate 16(30.8%) and extreme 3(5.7%). There is a difference of treatment response of antiobsessive therapy in male and female with statistical significance (p= 0.039). Conclusion: This study shows that obsessive compulsive disorder is most commonly found in 20-29 age group and the severe type is the most common. There is a significant difference in treatment response of antiobsessive therapy in male and female.

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A Clinical Validation of the Dysmorphic Concern Questionnaire

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2001.00860.x ◽

2001 ◽

Vol 35 (1) ◽

pp. 124-128 ◽

Cited By ~ 48

Author(s):

Lisa Jorgensen ◽

David Castle ◽

Clare Roberts ◽

Gary Groth-Marnat

Keyword(s):

Social Phobia ◽

Convergent Validity ◽

Body Dysmorphic Disorder ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

The Body ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Valid Instrument ◽

Relationship Of

Objective: The current study addressed the concept of dysmorphic concern as a symptom that may exist in a number of disorders. The aims of the study were to: (i) validate a recently developed questionnaire that measures dysmorphic concern, the Dysmorphic Concern Questionnaire (DCQ); and (ii) evaluate the relationship of dysmorphic concern to depressed mood, social phobia, and obsessive–compulsive symptomatology. Method: Sixty-five psychiatric inpatients were diagnosed using the computerized version of the Composite International Diagnostic Interview (CIDI-A). They then completed the DCQ, and questionnaires measuring body dysmorphic disorder (the Body Dysmorphic Disorder Examination, or BDDE), depression, social phobia, and obsessive–compulsive disorder (OCD). The factor structure and convergent validity of the DCQ were determined, and associations with mood and anxiety symptoms explored. Results: The DCQ was found to be a reliable and valid instrument that is sensitive to dysmorphic concern. Furthermore, although dysmorphic concern was associated with body dysmorphic disorder (BDD), depression, social phobia and OCD, only the score from the BDDE predicted DCQ score in a multiple regression analysis. Finally, BDD symptomatology was best defined by the presence of negative body beliefs as measured by the DCQ. Conclusions: Negative body beliefs are the hallmark of BDD. However, the existence of dysmorphic concern does not necessarily imply a diagnosis of BDD. The DCQ is a quick and efficient means of identifying dysmorphic concern in those who present with depression, OCD, social phobia or BDD.

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Level of Insight and Clinical Features of Obsessive-Compulsive Disorder with and Without Body Dysmorphic Disorder

CNS Spectrums ◽

10.1017/s1092852900021052 ◽

2007 ◽

Vol 12 (4) ◽

pp. 295-303 ◽

Cited By ~ 15

Author(s):

Ana Cristina Gargano Nakata ◽

Juliana B. Diniz ◽

Albina R. Torres ◽

Maria Alice de Mathis ◽

Victor Fossaluza ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Body Dysmorphic Disorder ◽

Study Groups ◽

Depression And Anxiety ◽

Obsessive Compulsive ◽

Statistical Manual ◽

Compulsive Disorder ◽

Diagnostic And Statistical Manual ◽

The University

ABSTRACTIntroduction: Body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) have several similarities and are included among the obsessive-compulsive spectrum of disorders. However, the content of preoccupations and level of insight of BDD patients differ from OCD patients.Objective: To compare the level of insight regarding obsessive-compulsive symptoms (OCS) and other clinical features in OCD patients with and without comorbid BDD.Methods: We evaluated 103 OCD patients (n=25, comorbid BDD), according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria using the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the University of São Paulo Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, and the Brown Assessment of Beliefs Scale.Results: The study groups differed significantly on several clinical features, including level of insight. A worse level of insight regarding OCS was independently associated with the presence of comorbid BDD. Lower educational level, more psychiatric comorbidities, presence of somatic and hoarding obsessions, and presence of intrusive images were associated with BDD comorbidity, even after adjusting for possible confounders.Conclusion: The presence of BDD in OCD patients is associated with poorer insight into obsessional beliefs and higher morbidity, reflected by lower educational levels and higher number of psychiatric comorbid disorders in general.

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Prevalence of Body Dysmorphic Disorder and Its Association with Other Mental Comorbidities Among a Group of College Students in Shiraz

Zahedan Journal of Research in Medical Sciences ◽

10.5812/zjrms.95247 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Abdulaziz Aflakseir ◽

Somayeh Jamali ◽

Javad Mollazadeh

Keyword(s):

College Students ◽

Eating Disorders ◽

Social Anxiety ◽

Obsessive Compulsive Disorder ◽

Body Dysmorphic Disorder ◽

The Body ◽

Eating Attitude ◽

Obsessive Compulsive ◽

Reassurance Seeking ◽

Compulsive Disorder

Background: Body dysmorphic disorder (BDD) is a relatively common and often severe psychiatric disorder. This disorder is a highly distressing disorder associated with poor quality of life. In addition, it is characterized by persistent and intrusive preoccupation with perceived defects or flaws in one’s physical appearance accompanied by repetitive behaviors such as mirror checking, excessive grooming, and reassurance seeking. Objectives: The purpose of this study was to examine the prevalence of BDD symptoms and body dissatisfaction among college students. Furthermore, the current study examined students’ checking behaviors and the parts of the body that they were most concerned about. This research also sought to examine the comorbidities associated with BDD symptoms, such as eating disorders, obsessive-compulsive disorder, depression, and social anxiety. Methods: A total of 750 college students were recruited from different schools of the Shiraz University, including Social Science, Engineering, Art, Education and Psychology, and Science and Art, using the cluster sampling method. Two classes were randomly selected in each school, and those who were volunteers took part in this study. Participants completed several questionnaires, including the Body Dysmorphic Disorder questionnaire, Beck Depression inventory, Maudsley Obsessive-Compulsive Disorder scale, Social Phobia inventory, and Eating Attitude test. To analyze the data, descriptive statistics such as frequency and percentage were used. Results: The results of this study showed that about 77% of college students were dissatisfied with at least one part of their bodies. The findings also revealed that the prevalence of BDD symptoms among college students was 4.5%. Furthermore, our results indicated that college students were mostly concerned about the appearance of their skin followed by hair, nose, weight, stomach, height, teeth, breast, and other parts of the body. In terms of checking behaviors, checking in front of a mirror, reassurance seeking, seeking treatment, and comparing themselves with others were the most common behaviors. The most prevalent comorbidity associated with BDD symptoms was obsessive compulsive disorder followed by social anxiety, depression, and eating disorders. Conclusions: This study highlighted that the majority of college students were dissatisfied with their bodies. This research also showed that college students are at high risk of mental health problems.

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Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

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