Body dysmorphic disorder Health Article

Demographics

As was mentioned earlier, BDD is primarily a disorder of young people. Its true incidence in the general population is unknown; however, it has been diagnosed in 1.9% of nonclinical patients and 12% of psychiatric outpatients. The DSM-IV-TRgives a range of 5%–40% for patients in clinical mental health settings diagnosed with anxiety or depressive disorders to be diagnosed with BDD. One community study published in 2001 found that 0.7% of women between the ages of 36 and 44 met the criteria for BDD. The disorder appears to be equally common in men and women.

As a result of gaps in research, little is known as of 2002 about the lifetime course of BDD or its prevalence in different ethnic or racial groups. The majority of patients in research studies to date have been Caucasians, but it is not clear whether this reflects racial patterns in the wider society or whether it represents referral bias, in that most study subjects are patients in private psychiatric hospitals. Anecdotal evidence, however, indicates that Asian Americans and African Americans with BDD are more likely to obsess about facial features or skin color that conflict with appearance ideals that dominate the mass media and have been derived from Caucasian people. Information through research done on the history of the American cosmetics industry reveals the startling statistic that African Americans spend three to five times as much money on personal care products as Caucasian Americans. In addition, successful African American and Asian American models, male as well as female, tend to resemble the Caucasian appearance ideal more than they deviate from it.

Diagnosis

The diagnosisof BDD in children and adolescents is often made by physicians in family practice because they are more likely to have developed long-term relationships of trust with the young people. With adults, it is often specialists in dermatology, cosmetic dentistry, or plastic surgery who may suspect that the patient suffers from BDD because of frequent requests for repeated or unnecessary procedures. Reported rates of BDD among dermatology and cosmetic surgery patients range between 6% and 15%. The diagnosis is made on the basis of the patient's history together with the physician's observations of the patient's overall mood and conversation patterns. People with BDD often come across to others as generally anxious and worried. In addition, the patient's dress or clothing styles may suggest a diagnosis of BDD.

As of 2002, there are no diagnostic questionnaires specifically for BDD, although a semi-structured interview called the BDD Data Form is sometimes used by researchers to collect information about the disorder from patients. The BDD Data Form includes demographic information, information about body areas of concern and the history and course of the illness, and the patient's history of hospitalizationor suicideattempts, if any. The diagnostic questionnaire most frequently used to identify BDD patients is the Structured Clinical Interview for DSM-III-R Disorders, or SCID-II.

There are no brain imaging studiesor laboratory tests as of 2002 that can be used to diagnose BDD.