A Retrospective Review of Clinical Characteristics and Treatment Response in Body Dysmorphic Disorder Versus Obsessive-Compulsive Disorder

Saxena, Sanjaya; Winograd, Arie M.; Dunkin, Jennifer J.; Maidment, Karron M.; Rosen, Richard; Vapnik, Tanya; Tarlow, Gerald; Bystritsky, Alexander

doi:10.4088/jcp.v62n0114b

Cited by 40 publications

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“…However, in our study, severity of depressive symptoms on the HAM-D did not significantly differ in the two groups. This latter finding is similar to that of McKay et al [1997; although power was limited for that study], but differs from Saxena et al's [2001] finding that subjects with BDD had higher HAM-D scores than subjects with OCD. Our finding that substance use disorders were significantly more common in subjects with BDD than in those with OCD concurs with the Frare et al study [2004] but not the previous Phillips et al study [1998].…”

Section: Discussionsupporting

confidence: 73%

Obsessive–compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders

et al. 2007

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The relationship between obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) is unclear. BDD has been proposed to be an OCD-spectrum disorder or even a type of OCD. However, few studies have directly compared these disorders' clinical features. We compared characteristics of subjects with OCD (n = 210), BDD (n = 45), and comorbid BDD/OCD (n = 40). OCD and BDD did not significantly differ in terms of demographic features, age of OCD or BDD onset, illness duration, and many other variables. However, subjects with BDD had significantly poorer insight than those with OCD and were more likely to be delusional. Subjects with BDD were also significantly more likely than those with OCD to have lifetime suicidal ideation, as well as lifetime major depressive disorder and a lifetime substance use disorder. The comorbid BDD/OCD group evidenced greater morbidity than subjects with OCD or BDD in a number of domains, but differences between the comorbid BDD/OCD group and the BDD group were no longer significant after controlling for BDD severity. However, differences between the comorbid BDD/OCD group and the OCD group remained significant after controlling for OCD severity. In summary, OCD and BDD did not significantly differ on many variables but did have some clinically important differences. These findings have implications for clinicians and for the classification of these disorders.

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Section: Discussionsupporting

confidence: 73%

Obsessive–compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders

et al. 2007

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“…A possible explanation for our sample's relatively higher IDS-SR scores (compared to HAM-D scores) is that the IDS-SR includes some items (e.g., interpersonal sensitivity) and wording (e.g., thinking about "defects" in oneself) that are characteristic of BDD and are not included in the HAM-D. In most prior BDD studies, HAM-D scores were in the moderate or moderate-severe range for the sample as a whole (e.g., Saxena et al, 2001). In one study (n=75), depression scores on the Symptom Questionnaire were higher than norms for normal controls (d=2.6) or psychiatric out-patients (d=.34), and were highly correlated with BDD severity (r=.60, p<.001) (Phillips et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder

Phillips

Didie

Menard

2007

Journal of Affective Disorders

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Background-Body dysmorphic disorder (BDD) and major depressive disorder (MDD) appear highly comorbid. However, MDD in individuals with BDD has received little investigation.Methods-The prevalence and characteristics of comorbid MDD were assessed in 178 BDD subjects. BDD subjects with current comorbid MDD (n=68) were compared to BDD subjects without current comorbid MDD (n=96) on demographic and clinical characteristics. Predictors of current MDD were determined using logistic regression.Results-74.2% of subjects had lifetime MDD, and 38.2% had current MDD. The melancholic subtype was most common, and a majority of depressed subjects had recurrent episodes. Mean onset of BDD occurred at a younger age than MDD. Subjects with current comorbid MDD had many similarities to those without MDD, although those with comorbid MDD had more severe BDD. Subjects with comorbid MDD were also more likely to have an anxiety or personality disorder, as well as a family history of MDD. They also had greater social anxiety, suicidality, and poorer functioning and quality of life. Current MDD was independently predicted by a personality disorder and more severe BDD.Limitations-It is unclear how generalizable the results are to the community or to subjects ascertained for MDD who have comorbid BDD. The study lacked a comparison group such as MDD subjects without BDD.Conclusions-MDD is common in individuals with BDD. Individuals with current MDD had greater morbidity in some clinically important domains, including suicidality, functioning, and quality of life. A personality disorder and more severe BDD independently predicted the presence of current MDD.

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“…(HAM-A) scale than patients with obsessive compulsive disorder (OCD) treated in the same setting (9); BDD patients' HAM-A scores were in the moderate to severe range. In a small open-label BDD fluvoxamine study (n = 12) by Perugi and colleagues, on the self-report Hopkins Symptom Checklist-90, subjects reported that they were distressed by depression "moderately" to "quite a bit" and by anxiety "a little bit" to "moderately" (10).…”

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confidence: 99%

Depression, Anxiety, Anger, and Somatic Symptoms in Patients with Body Dysmorphic Disorder

Phillips¹,

Siniscalchi²,

McElroy³

2004

Psychiatr Q

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Body dysmorphic disorder (BDD) is a relatively common and impairing disorder. However, little is known about non-BDD symptoms and well-being in patients with this disorder. Seventy-five outpatients with DSM-IV BDD completed the Symptom Questionnaire, a validated self-report measure with four scales: depression, anxiety, somatic/somatization, and anger-hostility. Scores were compared to published norms for normal subjects and psychiatric outpatients. Participants in an openlabel fluvoxamine trial completed the Symptom Questionnaire at baseline and endpoint. Compared to normal controls, BDD subjects had markedly elevated scores on all four scales, indicating severe distress and psychopathology. Compared to psychiatric patients, BDD subjects had higher scores on the depression, anxiety, and anger/hostility scales but not on the somatic/somatization scale. Scores on all scales significantly decreased with fluvoxamine. In conclusion, patients with BDD have markedly high levels of distress, are highly symptomatic, and have poor well-being in the domains of depression, anxiety, somatic symptoms, and anger-hostility. All of these symptoms significantly improved with fluvoxamine. Keywordsbody dysmorphic disorder; depression; anxiety; hostility; somatic symptoms Body dysmorphic disorder (BDD), also known as dysmorphophobia, is a distressing and relatively common disorder (1-4). BDD frequently causes impaired functioning, such as social isolation and difficulties in occupational and academic functioning (1,2). Patients with BDD also have notably poor mental health-related quality of life (5) and high lifetime rates of psychiatric hospitalization (48%), suicidal ideation (45%-82%), and suicide attempts (22%-24%) (1,6). However, relatively little is known about non-BDD symptoms and well-being in patients with BDD.Regarding non-BDD symptoms in patients with this disorder, BDD pharmacotherapy studies have reported mild to moderate depressive symptoms on the Hamilton Depression Rating Scale (HAM-D) (7,8) and the MADRS (8). A report of patients who were treated with medication, intensive cognitive behavioral therapy, and rehabilitation in a residential treatment setting found that BDD patients had higher pre-treatment scores on the HAM-D and Hamilton Anxiety (HAM-A) scale than patients with obsessive compulsive disorder (OCD) treated in the same setting (9); BDD patients' HAM-A scores were in the moderate to severe range. In a small open-label BDD fluvoxamine study (n = 12) by Perugi and colleagues, on the self-report Hopkins Symptom Checklist-90, subjects reported that they were distressed by depression "moderately" to "quite a bit" and by anxiety "a little bit" to "moderately" (10). BDD patients also have elevated levels of perceived stress, with scores that are notably higher than those in a large national probability sample and in most normal, medical, and psychiatric samples (11).In this study, we assessed symptoms and well-being in the domains of depression, anxiety, somatic/somatization, and anger-hostility using ...

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A Retrospective Review of Clinical Characteristics and Treatment Response in Body Dysmorphic Disorder Versus Obsessive-Compulsive Disorder

Cited by 40 publications

References 0 publications

Obsessive–compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders

Obsessive–compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders

Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder

Depression, Anxiety, Anger, and Somatic Symptoms in Patients with Body Dysmorphic Disorder

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