title: Body dysmorphic disorder in outpatients with major depression.
abstract: BACKGROUND
  Body dysmorphic disorder (BDD) is a distressing and impairing preoccupation with an imagined or slight defect in appearance, with depression as its most frequent comorbid condition. The purpose of this study was to evaluate the rate of BDD in a cohort of consecutive outpatients with typical and atypical major depressive disorder.
  
  
  METHODS
  Three hundred and fifty consecutive outpatient subjects with major depression who entered an antidepressant treatment study were evaluated drug-free with the SCID-P, SCID-II, a diagnostic module for BDD, and other measures. Depressed subjects with comorbid BDD were compared to those without BDD with regard to demographics, course of depression, comorbid conditions, and other relevant variables.
  
  
  RESULTS
  Twenty-eight (8.0%) subjects had a lifetime history of BDD and 23 (6.6%) had current BDD. Those with comorbid lifetime BDD had an earlier age of onset of depression and longer duration of the current episode, but not a greater number of depressive episodes or greater severity of depression. Subjects with and without BDD were similar with respect to age, gender, and marital status. There was a higher rate of lifetime and current BDD in subjects with atypical depression than in those with non-atypical depression (14.4% compared to 5.1%; chi2 = 6.63; P = 0.01: 11.6% vs. 4.1%; chi2 = 7.02; P = 0.02). Subjects with BDD also had higher rates of social phobia, any eating disorder, and any somatoform disorder but not obsessive compulsive disorder. They also had higher rates of avoidant, histrionic, and dependent personality disorders.
  
  
  CONCLUSIONS
  As we did not specifically examine bipolar spectrum conditions, the present study cannot address to what extent BDD is comorbid with Bipolar-II disorder.
  
  
  CONCLUSIONS
  BDD is frequently comorbid with major depression, is associated with an earlier age of onset of depression and longer duration of depressive episodes, and is found more frequently with atypical than non-atypical depression.
authors.affiliation: Depression Research Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital and The Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA anierenberg@partners.org
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Phillips
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Petersen
authors.forename: Karen E
authors.initials: KE
authors.lastname: Kelly
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Alpert
authors.forename: John J
authors.initials: JJ
authors.lastname: Worthington
authors.forename: Joyce R
authors.initials: JR
authors.lastname: Tedlow
authors.forename: Jerrold F
authors.initials: JF
authors.lastname: Rosenbaum
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients; D010698:Phobic Disorders / Q000150:complications / Q000523:psychology; D013001:Somatoform Disorders / Q000150:complications* / Q000523:psychology