title: Level of insight and clinical features of obsessive-compulsive disorder with and without body dysmorphic disorder.
abstract: BACKGROUND
  Body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) have several similarities and are included among the obsessive-compulsive spectrum of disorders. However, the content of preoccupations and level of insight of BDD patients differ from OCD patients.
  
  
  OBJECTIVE
  To compare the level of insight regarding obsessive-compulsive symptoms (OCS) and other clinical features in OCD patients with and without comorbid BDD.
  
  
  METHODS
  We evaluated 103 OCD patients (n=25, comorbid BDD), according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria using the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, and the Brown Assessment of Beliefs Scale.
  
  
  RESULTS
  The study groups differed significantly on several clinical features, including level of insight. A worse level of insight regarding OCS was independently associated with the presence of comorbid BDD. Lower educational level, more psychiatric comorbidities, presence of somatic and hoarding obsessions, and presence of intrusive images were associated with BDD comorbidity, even after adjusting for possible confounders.
  
  
  CONCLUSIONS
  The presence of BDD in OCD patients is associated with poorer insight into obsessional beliefs and higher morbidity, reflected by lower educational levels and higher number of psychiatric comorbid disorders in general.
authors.affiliation: Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. ananakata@yahoo.com.br
authors.forename: Ana Cristina Gargano
authors.initials: AC
authors.lastname: Nakata
authors.forename: Juliana B
authors.initials: JB
authors.lastname: Diniz
authors.forename: Albina R
authors.initials: AR
authors.lastname: Torres
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: de Mathis
authors.forename: Victor
authors.initials: V
authors.lastname: Fossaluza
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Bragancas
authors.forename: Ygor
authors.initials: Y
authors.lastname: Ferrão
authors.forename: Euripedes C
authors.initials: EC
authors.lastname: Miguel
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D001938:Brazil; D015897:Comorbidity; D003469:Culture; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D013001:Somatoform Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*