Charting the Course of Body Dysmorphic Disorder

Body dysmorphic disorder (BDD), is a distressing, often impairing, preoccupation with a slight or imagined defect in one’s physical appearance. Until recently, little was known about the course of BDD. In what is believed to be the first prospective follow-up study of BDD patients, researchers at Brown Medical School have found that BDD tends to be chronic (Am J Psychiatry 2006; 163:907).

Katherine A. Phillips, MD and colleagues obtained data with the Longitudinal Interval Follow-up Evaluation on weekly BDD symptom status and treatment received over a year for 183 subjects. The subjects were comprehensively evaluated at intake with self-reports and other measures.

Outcome: Higher-than-Expected Relapse Rates

A total of 154 subjects (84%) reported receiving mental health treatment during the one year of follow-up, but only (47.5%) reported receiving treatment specifically for their BDD symptoms. Only 16% reported having an optimally adequate experience with psychotropic medications. Only 9% reported full remission from BDD symptoms, and 15% of these subsequently relapsed. Gender and ethnicity did not predict remission.