Axis I comorbidity in body dysmorphic disorder
Section snippets
Method
Subjects were referred from a variety of sources to a BDD research program for evaluation or treatment of BDD. All participants met DSM-IV criteria for BDD or its delusional variant (a type of delusional disorder, somatic type), which may be double-coded with BDD according to DSM-IV. There were 293 participants: 175 participated in a phenomenology study of BDD’s clinical features,3 31 in an open-label study of fluvoxamine for BDD,20 and 87 in placebo-controlled pharmacotherapy studies of BDD.21
Results
Lifetime comorbidity was common (Table 2). Among both phenomenology and treatment study participants, major depression was most frequent, followed by social phobia, OCD, and substance use disorders. Comorbidity rates were generally similar in the phenomenology and treatment groups. The lower rates of bipolar disorder and substance use disorders in the treatment group were expected because of the treatment studies’ exclusion criteria.
Phenomenology study participants had 2.4 ± 1.5 lifetime
Discussion
This study found that comorbidity is common in BDD patients, both in terms of the percentage of patients with at least one comorbid disorder and the mean number of comorbid disorders. Indeed, comorbidity is the rule rather than the exception, as is the case for many psychiatric disorders.25 While the differing comorbidity rates in our phenomenology and treatment studies were expected, these differences underscore that rates may vary in different samples. It is possible, for example, that
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