Zimmerman, M., Mattia, J.I. Body dysmorphic disorder in psychiatric
outpatients: Recognition, prevalence, comorbidity, demographic, and
clinical correlates. Comprehensive Psychiatry, 1998, 39,
265-270.
The prevalence of Body Dysmorphic Disorder (BDD), based on structured
and unstructured clinical interviews, was compared in two samples of
psychiatric outpatients drawn from the same practice setting. In the first
sample, 500 patients were diagnosed according to a routine unstructured
clinical interview. In the second sample, 500 subjects were diagnosed
according to information obtained by the Structured Clinical Interview for
DSM-IV (SCID). No patient was diagnosed with BDD in the clinical sample,
whereas 16 (3.2%) patients were diagnosed with BDD in the SCID sample.
Compared to patients without BDD, patients with BDD received significantly
more current Axis I diagnoses and were more likely to be diagnosed with
current obsessive-compulsive disorder and social phobia. Both groups were
diagnosed with major depression at similar rates. Patients with BDD,
versus those without, tended to be sicker and more functionally impaired.
It appears that BDD is an infrequent disorder in an outpatient setting
that is rarely recognized when clinicians conduct their routine diagnostic
interview. Although it was not usually a patient's principal reason for
seeking treatment, the majority of patients with BDD in this sample wanted
their treatment to address these symptoms.
