Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance.
OBJECTIVE
The current study examined comorbidity and clinical correlates of eating disorders in a large sample of individuals with body dysmorphic disorder (BDD).


METHODS
Two hundred individuals with DSM-IV (4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994) BDD completed reliable interviewer-administered and self-report measures, including diagnostic assessments and measures of body image, symptom severity, delusionality, psychosocial functioning, quality of life (QOL), and history of psychiatric treatment.


RESULTS
A total of 32.5% of BDD subjects had a comorbid lifetime eating disorder: 9.0% had anorexia nervosa, 6.5% had bulimia nervosa, and 17.5% had an eating disorder not otherwise specified. Comparisons of subjects with a comorbid lifetime eating disorder (n = 65) and subjects without an eating disorder (n = 135) indicated that the comorbid group was more likely to be female, less likely to be African American, had more comorbidity, and had significantly greater body image disturbance and dissatisfaction. There were no significant group differences in BDD symptom severity, degree of delusionality, or suicidal ideation or attempts. Functioning and QOL were notably poor in both groups, with no significant between-group differences. However, a higher proportion of the comorbid eating disorder group had been hospitalized for psychiatric problems. This group had also received a greater number of psychotherapy sessions and psychotropic medications.


CONCLUSIONS
Eating disorders appear relatively common in individuals with BDD. BDD subjects with a comorbid eating disorder differed on several demographic variables, had greater comorbidity and body image disturbance, and had received more mental health treatment than subjects without a comorbid eating disorder. These findings have important implications for the assessment and treatment of these comorbid body image disorders.
Ruffolo
Jessica S
JS
Butler Hospital, Providence, Rhode Island 02906, USA.
Phillips
Katharine A
KA
Menard
William
W
Fay
Christina
C
Weisberg
Risa B
RB
D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D011584:Psychology; D011613:Psychotherapy / Q000379:methods; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D012917:Social Adjustment; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology*
D011619:Psychotropic Drugs