Elsevier

Comprehensive Psychiatry

Volume 44, Issue 5, September–October 2003, Pages 415-419
Comprehensive Psychiatry

Body dysmorphic disorder in patients with acne

https://doi.org/10.1016/S0010-440X(03)00102-0Get rights and content

Abstract

There is growing evidence that the prevalence of body dysmorphic disorder (BDD) is significantly higher in specially selected populations as compared to the general population. The goal of the current study was to evaluate prevalence of BDD in Turkish patients with mild acne presenting to a dermatologist for treatment. This study was the first empirical investigation of BDD in acne patients in Turkey. One hundred fifty-nine outpatients diagnosed with acne who consulted to the dermatology clinic were included in the study. The diagnosis of BDD was based on DSM-IV criteria and the Structured Clinical Interview for DSM-IV (SCID-I). A study-specific questionnaire was administered to document and investigate the demographic and clinical characteristics of the cases. Fourteen (8.8%) patients were diagnosed with BDD. Three (21.4%) patients with acne and BDD also had concomitant psychiatric diagnoses. All of the patients were psychiatric management-naive, never received any psychological or physical treatments. BDD was a common psychiatric condition in acne cases. We suggest that dermatologists should routinely explore symptoms and screen such patients for BDD.

Section snippets

Participants

Participants were consecutive outpatient diagnosed with acne who applied to the general dermatology outpatient unit (Department of Dermatology, Gülhane School of Medicine, Ankara, Turkey) between February 2000 and March 2001. The original sample included 718 subjects. However, 541 subjects with moderate or severe acne were excluded from the study. Sixteen of the subjects who were asked to participate did not wish to take part, and two subjects who had a real defect of appearance and whose

Results

Of the 159 subjects assessed, 35.8% (n = 57) were found to have dissatisfaction with some aspect of appearance. However, in the clinical evaluation only 8.8% (14/159) fulfilled the criteria for BDD.

Of the 14 acne patients with BDD, eight (57.1%) were male and six (42.9%) were female. In the non-BDD group, 79 (54.5%) were male and 66 (45.5%) were female. The difference between the two groups was not statistically significant (Fisher’s exact test, P > .05). Patients with BDD were significantly

Discussion

To our knowledge this report is the first empirical investigation of the prevalence of BDD in acne patients. We demonstrated that 8.8% of the patients with mild acne were diagnosed with BDD. Our results differ from those of Phillips et al.,10 who found that the rate of BDD in 268 patients seeking dermatologic treatment was 11.9%. However, their study sample was not limited to acne patients. The relatively low rates in our study also may due to the differences in methodologies. Phillips et al.

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      Previous studies have shown that BDD is more common in patients seeking plastic surgery interventions and those attending dermatology clinics than in the asymptomatic general population.14,19,20 Cumulative prevalence of BDD in dermatology patients in the present study (36.0%) was close to that reported by Bowe et al. (35.16%) and higher than the 8.81% described by Ozun et al. and 11.94% reported by Phillips et al.21-23, which included only participants with acne vulgaris. The factors that could affect the prevalence of BDD vary widely according to the assessment methods, study site, societal values, cultural norms, the survey’s setting, and the skin diseases targeted by the study.1,23

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