Prevalence and Clinical Features of Body Dismorphic Disorder on Psychiatric Inpatients: A Cross-sectional Study in Edirne/TURKEY

Öz

Aim: Body dysmorphic disorder (BDD) is characterized by the presence of an imaginary defect of oneself and an increased mental occupation which causes either an impairment in functionality or clinical distress. The aim of our study was to detect BDD prevalence and its clinical features in hospitalized psychiatric patients. Material and Method: Hospitalized patients in our clinics were evaluated. All the patients in our study were evaluated by using a questionnaire that was prepared in accordance with the BDD literature by the authors, a sociodemographic data form, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and Structured Clinical Interview for Axis II Disorders (SCID-II). Results: BDD prevalence was found to be 7% in hospitalized psychiatric patients. It was also observed that all patients with BDD had self-image anxiety, had mirror checking behaviour, tended to camuflage the perceived defect, spent more than one hour in selfimage anxiety and had personality disorders. Howeve, none of the BDD patients ever mentioned any symptoms related to BDD unless they were asked and none of them had been diagnosed with BDD by the psychiatric team who were treating them. Conclusion: BDD is relatively common in hospitalized psychiatric patients. Therefore most BDD patients are not diagnosed. BDD diagnosis rate might be improved by questioning BDD as well as inspecting self-image anxiety. 

Anahtar Kelimeler

• body dysmorphic disorder; prevalence; inpatients; body image

Yatarak Tedavi Gören Psikiyatri Hastalarında Beden Dismorfik Bozukluğu Yaygınlığı ve Özellikleri: Edirne/TÜRKİYE’de Kesitsel Bir Araştırma

Öz

Amaç: Beden dismorfik bozukluğu (BDB), klinik olarak belirgin sıkıntı yaratan veya işlevselliğin önemli alanlarında bozukluğa yol açan, kişinin görünüşündeki hayali bir kusur ile artmış zihinsel uğ- raşın varlığı ile karakterizedir. Yatarak tedavi gören psikiyatri hastalarında BDB yaygınlığını ve klinik özelliklerini belirlemeyi amaçladık. Materyal ve Metot: Kliniğimizde çeşitli nedenlerle yatarak tedavi gö- ren hastalar değerlendirildi. Çalışmaya katılan her hasta tarafımızdan hazırlanan sosyodemografik veriler ve BDB ile ilgili sorulardan oluşturduğumuz anket formu, Structured Clinical Interview for DSM-IV Axis I Disorders DSM-IV Eksen I Bozuklukları İçin Yapılandırılmış Klinik Görüşme (SCID-I) ve II. Eksen Kişilik Bozuklukları İçin Yapılandırılmış Klinik Görüşme (SCID-II) kullanılarak değerlendirildi. Bulgular: Yatarak tedavi gören psikiyatri hastalarında BDB yaygınlığını %7 olarak tespit edildi. BDB’li hastaların tamamında görünüm endişesi, ayna kontrolü, kusurlu bulduğu bölgeyi gizleme davranışı, görünüm endişesi ile ilgili olarak bir saatten fazla zaman harcama davranışı ve kişilik bozukluğu olduğu, ayrıca hiçbir BDB’lu hastanın sorulmadıkça BDB ile ilgili belirtiyi söylemediği ve hiç birinin BDB teşhisinin tedaviyi yürüten ekipçe koyulamadığı bulundu. Sonuç: Yatarak tedavi gören pskiyatri kliniği hastalarında BDB nispeten yaygın bir hastalıktır. Bu duruma rağmen teşhis edilememektedir. Bdb ye yönelik görünüm endişesi yanında kolayca sorgulanabilecek sorularla inceleme BDB teşhis oranını artırabilir.

Anahtar Kelimeler

• beden dismorfik bozukluğu; yaygınlık; hastane yatarak tedavi; beden imajı

Kaynakça

1. 1. Fang A, Wilhelm S. Clinical features, cognitive biases, and treatment of body dysmorphic disorder. Annu Rev Clin Psychol2015;11:187–212.
2. 2. Phillips KA. The Presentation of Body Dysmorphic Disorder in Medical Settings. Prim Psychiatry 2006;13(7):51–9.
3. 3. Fang A, Matheny NL, Wilhelm S. Body dysmorphic disorder. Psychiatr Clin North Am 2014;37(3):287–300.
4. 4. Sadock BJ, Sadock VA, MD DPR. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Eleventh edition. LWW; 2014. p.1472.
5. 5. Association AP. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5 edition. Washington, D. C.: American Psychiatric Publishing; 2013. p.991.
6. 6. Marques L, Weingarden HM, Leblanc NJ, Wilhelm S. Treatment utilization and barriers to treatment engagement among people with body dysmorphic symptoms. J Psychosom Res 2011;70(3):286–93.
7. 7. Phillips KA. Psychosis in body dysmorphic disorder. J Psychiatr Res 2004;38(1):63–72.
8. 8. Veale D, Akyüz EU, Hodsoll J. Prevalence of body dysmorphic disorder on a psychiatric inpatient ward and the value of a screening question. Psychiatry Res 2015;230(2):383–6.

9. 9. Phillips KA. Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis 2000;188(3):170–5.
10. 10. Phillips KA, Menard W, Fay C, Pagano ME. Psychosocial functioning and quality of life in body dysmorphic disorder. Compr Psychiatry 2005;46(4):254–60.
11. 11. Phillips KA. Suicidality in Body Dysmorphic Disorder. Prim Psychiatry 2007;14(12):58–66.
12. 12. Conrado LA, Hounie AG, Diniz JB, Fossaluza V, Torres AR, Miguel EC, et al. Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features. J Am Acad Dermatol 2010;63(2):235–43.
13. 13. Alavi M, Kalafi Y, Dehbozorgi GR, Javadpour A. Body dysmorphic disorder and other psychiatric morbidity in aesthetic rhinoplasty candidates. J Plast Reconstr Aesthetic Surg 2011;64(6):738–41.
14. 14. Vinkers DJ, van Rood YR, van der Wee NJA. Prevalenceand comorbidity of body dysmorphic disorder in psychiatric outpatients. Tijdschr Psychiatr 2008;50(9):559–65.
15. 15. Zimmerman M, Mattia JI. Body dysmorphic disorder in psychiatric outpatients: recognition, prevalence, comorbidity, demographic, and clinical correlates. Compr Psychiatry 1998;39(5):265–70.
16. 16. Kollei I, Martin A, Rein K, Rotter A, Jacobi A, Mueller A. Prevalence of body dysmorphic disorder in a German psychiatric inpatient sample. Psychiatry Res 2011;189(1):153–5.
17. 17. Grant JE, Kim SW, Crow SJ. Prevalence and clinical features of body dysmorphic disorder in adolescent and adult psychiatric inpatients. J Clin Psychiatry 2001;62(7):517–22.
18. 18. Conroy M, Menard W, Fleming-Ives K, Modha P, Cerullo H, Phillips KA. Prevalence and clinical characteristics of body dysmorphic disorder in an adult inpatient setting. Gen Hosp Psychiatry 2008;30(1):67–72.
19. 19. Veale D, Gledhill LJ, Christodoulou P, Hodsoll J. Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image 2016;18:168–86.
20. 20. First MB, Spitzer RL, Gibbon M, And Williams, Janet BW. Structured clinical interview for DSM-IV clinical version (SCID-I/CV). Washington DC. American Psychiatric Press; 1997.
21. 21. Özkürkçügil A, Aydemir Ö, Yıldız M, et al. IV E. DSM-IV Validity and Reliability of the Turkish Translation of Structured Clinical Interview for Axis Disorders. İlaç ve Tedavi Derg 1999;12(4):233–6.
22. 22. Spitzer RL, Williams JBW, Gibbon M, et al. Manual for the structured clinical interview for DSM-III-R personality disorders. Wash DC 1990;7.
23. 23. Coşkunol H, Bağdiken I, Sorias S. Validity of SCIDII for personality disorders 28th National Psychiatry Congress Ank 1992.
24. 24. Dyl J, Kittler J, Phillips KA, Hunt JI. Body dysmorphic disorder and other clinically significant body image concerns in adolescent psychiatric inpatients: prevalence and clinical characteristics. Child Psychiatry Hum Dev 2006;36(4):369–82.