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Rautio D, Jassi A, Krebs G, Andrén P, Monzani B, Gumpert M, Lewis A, Peile L, Sevilla-Cermeño L, Jansson-Fröjmark M, Lundgren T, Hillborg M, Silverberg-Morse M, Clark B, Fernández de la Cruz L, Mataix-Cols D. Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. Eur Child Adolesc Psychiatry 2022; 31:133-144. [PMID: 33165651 PMCID: PMC8817062 DOI: 10.1007/s00787-020-01677-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/25/2020] [Indexed: 11/06/2022]
Abstract
Body dysmorphic disorder (BDD) often starts in childhood, with most cases developing symptoms before age 18. Yet, BDD research has primarily focused on adults. We report the clinical characteristics of the world's largest cohort of carefully diagnosed youths with BDD and focus on previously unexplored sex and age differences. We systematically collected clinical data from 172 young people with BDD consecutively referred to 2 specialist pediatric obsessive-compulsive and related disorders outpatient clinics in Stockholm, Sweden and in London, England. A series of clinician-, self-, and parent-reported measures were administered. The cohort consisted of 136 girls, 32 boys, and 4 transgender individuals (age range 10-19 years). The mean severity of BDD symptoms was in the moderate to severe range, with more than one third presenting with severe symptoms and more than half showing poor or absent insight/delusional beliefs. We observed high rates of current psychiatric comorbidity (71.5%), past or current self-harm (52.1%), suicide attempts (11.0%), current desire for cosmetic procedures (53.7%), and complete school dropout (32.4%). Compared to boys, girls had significantly more severe self-reported BDD symptoms, depression, suicidal thoughts, and self-harm. Compared to the younger participants (14 or younger), older participants had significantly more severe compulsions and were more likely to report a desire for conducting cosmetic procedures. Adolescent BDD can be a severe and disabling disorder associated with significant risks and substantial functional impairment. The clinical presentation of the disorder is largely similar across sexes and age groups, indicating the importance of early detection and treatment. More research is needed specifically focusing on boys and pre-pubertal individuals with BDD.
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Affiliation(s)
- Daniel Rautio
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden.
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Amita Jassi
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Georgina Krebs
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Per Andrén
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Benedetta Monzani
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Martina Gumpert
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Angela Lewis
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lauren Peile
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Laura Sevilla-Cermeño
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain
| | - Markus Jansson-Fröjmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
| | - Maria Hillborg
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | | | - Bruce Clark
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lorena Fernández de la Cruz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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