Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-28T14:02:06.066Z Has data issue: false hasContentIssue false

The Prevalence of Body Dysmorphic Disorder in the United States Adult Population

Published online by Cambridge University Press:  07 November 2014

Abstract

Objective:

In clinical samples, body dysmorphic disorder (BDD) is associated with substantial suffering and reduced quality of life. Limited surveys report widely varying prevalence estimates. To better establish the prevalence of BDD, we conducted a United States nationwide prevalence survey.

Method:

We conducted a random sample national household telephone survey in the spring and summer of 2004 and interviewed 2,513 adults, of whom 2,048 qualified for the BDD-module administration. The computer-assisted, structured interviews, conducted by trained lay interviewers, addressed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for BDD, along with information regarding several impulse-control disorders and the respondents' financial and demographic data.

Results:

The rate of response was 56.3%, which compared favorably with rates in federal national health surveys. The cooperation rate was 97.6%. Respondents included a higher percentage of women and people >55 years of age than in the US adult population, and a lower percentage of Hispanics. The estimated point prevalence of DSM-IV BDD among respondents was 2.4% (49/2,048) (by gender: 2.5% for women, 2.2% for men), exceeding the prevalence of schizophrenia and bipolar disorder type I and about that of generalized anxiety disorder. BDD prevalence decreased after 44 years of age, and a larger proportion of BDD respondents were never married. Of those meeting DSM-IV criteria for BDD, 90% (45/49) met the DSM-IV distress criterion, and 51% (25/49) met the interference-with-functioning criterion.

Conclusion:

A study using clinically valid interviews is needed to evaluate these results. Such studies could inform treatment by documenting rates of seeking treatment from various sources, suicide attempt rates, and the prevalence of comorbid conditions.

Type
Original Research
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Phillips, KA, McElroy, SL, Keck, PE Jr, Pope, HG Jr, Hudson, JI. Body dysmorphic disorder: 30 cases of imagined ugliness. Am J Psychiatry. 1993;150:302308.Google ScholarPubMed
2.Veale, D, Boocock, A, Gournay, K, Dryden, W, Shah, F, Wilson, R, Walburn, J. Body dysmorphic disorder: a survey of fifty cases. Br J Psychiatry. 1996;169:196201.CrossRefGoogle ScholarPubMed
3.Perugi, G, Giannotti, D, Frare, F, et al.Prevalence, phenomenology, and comorbidity of body dysmorphic disorder (dysmorphophobia) in a clinical population. Int J Psychiatry Clin Pract. 1997;1:7782.CrossRefGoogle Scholar
4.DeMarco, LM, Li, LC, Phillips, KA, McElroy, SL. Perceived stress in body dysmorphic disorder. J Nerv Merit Dis. 1998;186:724726.Google Scholar
5.Phillips, KA, Menard, W, Fay, C, Pagano, ME. Psychosocial functioning and quality of life in body dysmorphic disorder. Compr Psychiatry. 2005;46:254260.Google Scholar
6.Phillips, KA, Menard, W. Suicidality in body dysmorphic disorder: a prospective study. Am J Psychiatry. 2006;163:12801282.Google Scholar
7.Rief, W, Buhlmann, U, Wilhelm, S, Borkenhagen, A, Brähler, E. The prevalence of body dysmorphic disorder: a population-based survey. Psychol Med. 2006;36:877885.CrossRefGoogle ScholarPubMed
8.Otto, MW, Wilhelm, S, Cohen, L, Harlow, BL. Prevalence of body dysmorphic disorder in a community sample of women. Am J Psychiatry. 2001;158:20612063.CrossRefGoogle Scholar
9.Faravelli, C, Salvatory, S, Galassi, G, Aiazzi, L, Drei, C, Cabras, P. Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychiatr Epidemiol. 1997;32:2429.CrossRefGoogle ScholarPubMed
10.Bienvenu, OJ, Samuels, JF, Riddle, MA, et al.The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry. 2000;48:287293.Google Scholar
11.Bohne, A, Wilhelm, S, Keuthen, NJ, Florin, I, Baer, L, Jenike, MA. Prevalence of body dysmorphic disorder in a German college student sample. Psychiatry Res. 2002;109:101104.Google Scholar
12.Biby, EL. The relationship between body dysmorphic disorder and depression, self-esteem, somatization, and obsessive-compulsive disorder. J Clin Psychol. 1998;54:489499.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
13.Bohne, A, Keuthen, NJ, Wilhelm, S, Deckersbach, T, Jenike, MA. Prevalence of symptoms of body dysmorphic disorder and its correlates: a cross-cultural comparison. Psychosomatics. 2002;43:486490.Google Scholar
14.Sarwer, DB, Cash, TF, Magee, L, et al.Female college students and cosmetic surgery: an investigation of experiences, attitudes, and body image. Plast Reconstr Surg. 2005;115:931938.Google Scholar
15.Fitts, SN, Gibson, P, Redding, CA, Deiter, PJ. Body dysmorphic disorder: implications for its validity as a DSM-III-R clinical syndrome. Psychol Rep. 1989;64:655658.CrossRefGoogle ScholarPubMed
16.Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. The American Association for Public Opinion Research: Ann Arbor, Mich: AAPOR; 2000.Google Scholar
17.Behavioral Risk Factor Surveillance System. Behavioral Risk Factor Surveillance System Summary Data Quality Report. Centers for Disease Control and Prevention: Atlanta, Ga; 2004.Google Scholar
18.Phillips, KA. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder, rev ed. New York, NY: Oxford University Press; 2005.Google Scholar
19.Kessler, RC, Keller, MB, Wittchen, HU. The epidemiology of generalized anxiety disorder. Psychiatr Clin North Am. 2001;24:1939.Google Scholar
20.Phillips, KA, Gunderson, CG, Mallya, G, McElroy, SL, Carter, W. A comparison study of body dysmorphic disorder and obsessive-compulsive disorder. J Clin Psychiatry. 1998;59:568575.CrossRefGoogle ScholarPubMed
21.Phillips, KA, Pinto, A, Menard, W, Eisen, JL, Mancebo, M, Rasmussen, SA. Obsessive-compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders. Depress Anxiety. 2007;24:399409.CrossRefGoogle ScholarPubMed
22.Phillips, KA. The presentation of body dysmorphic disorder in medical settings. Primary Psychiatry. 2006;13:5159.Google Scholar
23.Phillips, KA, Menard, W, Fay, C, Weisberg, R. Demographic characteristics, phenomenology, comorbidity and family history in 200 individuals with body dysmorphic disorder. Psychosomatics. 2005;46:317332.Google Scholar
24.Pope, HG Jr, Gruber, AJ, Choi, P, Olivardia, R, Phillips, KA. Muscle dysmorphia. An under-recognized form of body dysmorphic disorder. Psychosomatics. 1997;38:548557.CrossRefGoogle Scholar
25.Phillips, KA, Diaz, S. Gender differences in body dysmorphic disorder. J Nerv Ment Dis. 1997;185:570577.Google Scholar
26.Moller-Leimkuhler, AM. Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord. 2002;71:19.Google Scholar
27.Phillips, KA, Pagano, ME, Menard, W, Stout, RL. A 12-month follow-up study of the course of body dysmorphic disorder. Am J Psychiatry. 2006;163:907912.CrossRefGoogle ScholarPubMed
28.Hollander, E, Cohen, LJ, Simeon, D. Body dysmorphic disorder. Psychiatr Ann. 1993;23:359364.Google Scholar
29.Phillips, KA. Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis. 2000;188:170175.Google Scholar