The Relationship of Body Dysmorphic Disorder to Obsessive-Compulsive Disorder and the Concept of the Obsessive-Compulsive Spectrum
This chapter describes the relationship of body dysmorphic disorder (BDD) to obsessive-compulsive disorder (OCD) and the concept of the obsessive-compulsive spectrum. BDD is proposed to be part of an obsessive-compulsive spectrum of disorders, given its many similarities to OCD. OCD and BDD are both characterized by obsessions and compulsions, although in BDD individuals focus specifically on body image concerns, whereas in OCD they typically focus on concerns such as contamination, harm, and aggression. Distress that results from obsessions usually generates compulsive behaviors intended to reduce emotional discomfort. Individuals with BDD are more likely to have delusional beliefs and significantly poorer insight. Individuals with BDD report higher rates of major depressive disorder, substance use disorders, suicidal thoughts, and suicide attempts. OCD and BDD demonstrate familiality, indicating that they are likely related conditions. OCD and BDD are thought to be heterogeneous disorders that result from both genetic and environmental factors, some of which appear to be shared; for example, they appear to share some abnormalities involving the basal ganglia and limbic system (specifically the caudate nucleus).