Body dysmorphic disorder in patients with acne: a multicentre study

Abstract

Background and objective Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM‐IV and DSM‐5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. Methods A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. Results In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6–13.6%). The prevalence was the same with DSM‐IV or DSM‐5 criteria. Possible cases of BDD were predominantly women (P = 0.021), and 56% had non‐inflammatory lesions vs. 30% of negative patients (P = 0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make‐up (72.1%). Conclusions As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.

A case of body dysmorphic disorder in an adolescent with hypohidrotic ectodermal dysplasia

“…The patient felt strongly that medical interventions for his appearance concerns would dissipate his anxiety about his appearance, but unfortunately the procedures did not improve his BDD symptoms. Persons with BDD are more likely to seek out nonpsychiatric medical treatment such as surgical procedures or dermatologic interventions over psychiatric treatment for BDD 9,10 . The most common complaints in dermatology clinic patients with BDD include acne, nevi, tumors, hair disorders, and scarring 10 .…”

“…Persons with BDD are more likely to seek out nonpsychiatric medical treatment such as surgical procedures or dermatologic interventions over psychiatric treatment for BDD 9,10 . The most common complaints in dermatology clinic patients with BDD include acne, nevi, tumors, hair disorders, and scarring 10 . A naturalistic, prospective (n = 200) study showed that patients with BDD received dermatologic (antibiotics, minoxidil, isotretinoin, and dermabrasion) or surgical interventions in 64% of cases 11 .…”

Psychodermatology of acne: Dermatologist's guide to inner side of acne and management approach

“…People are particularly concerned about their faces, and this takes at least 2 hours a day. 44 In a study conducted with patients with severe acne, 13% of cases had obsessive compulsive personality disorder. 45 In patients with body dysmorphic disorder, looking in the mirror is often seen as a compulsion.…”

“…In the study using Body Dysmorphic Disorder Questionnaire, this disorder was more common in female patients and patients with inflammatory lesions. People are particularly concerned about their faces, and this takes at least 2 hours a day 44 . In a study conducted with patients with severe acne, 13% of cases had obsessive compulsive personality disorder 45 .…”

Acne is a disease of civilization

“…депрессии) в связи с угревой болезнью [5,6]. Наличие угревой сыпи на видимых участках кожи может вызывать дисморфофобию (представление о мнимом внешнем уродстве) [7].…”