Body dysmorphic disorder in outpatients with major depression

Andrew A. Nierenberg, Katharine A. Phillips, Timothy J. Petersen, Karen E. Kelly, Jonathan E. Alpert, John J. Worthington, Joyce R. Tedlow, Jerrold F. Rosenbaum, Maurizio Fava

Research output: Contribution to journalArticle

46 Citations (Scopus)

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%; χ2=6.63; P=0.01: 11.6% vs. 4.1%; χ2=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. Limitations: 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.

Original languageEnglish (US)
Pages (from-to)141-148
Number of pages8
JournalJournal of Affective Disorders
Volume69
Issue number1-3
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Body Dysmorphic Disorders
Outpatients
Depression
Age of Onset
Dependent Personality Disorder
Histrionic Personality Disorder
Somatoform Disorders
Obsessive-Compulsive Disorder
Personality Disorders
Major Depressive Disorder
Marital Status
Bipolar Disorder

Keywords

  • Atypical depression
  • Axis I comorbidity
  • Body dysmorphic disorder
  • Major depression

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

Nierenberg, A. A., Phillips, K. A., Petersen, T. J., Kelly, K. E., Alpert, J. E., Worthington, J. J., ... Fava, M. (2002). Body dysmorphic disorder in outpatients with major depression. Journal of Affective Disorders, 69(1-3), 141-148. https://doi.org/10.1016/S0165-0327(01)00304-4

Body dysmorphic disorder in outpatients with major depression. / Nierenberg, Andrew A.; Phillips, Katharine A.; Petersen, Timothy J.; Kelly, Karen E.; Alpert, Jonathan E.; Worthington, John J.; Tedlow, Joyce R.; Rosenbaum, Jerrold F.; Fava, Maurizio.

In: Journal of Affective Disorders, Vol. 69, No. 1-3, 2002, p. 141-148.

Research output: Contribution to journalArticle

Nierenberg, AA, Phillips, KA, Petersen, TJ, Kelly, KE, Alpert, JE, Worthington, JJ, Tedlow, JR, Rosenbaum, JF & Fava, M 2002, 'Body dysmorphic disorder in outpatients with major depression', Journal of Affective Disorders, vol. 69, no. 1-3, pp. 141-148. https://doi.org/10.1016/S0165-0327(01)00304-4
Nierenberg AA, Phillips KA, Petersen TJ, Kelly KE, Alpert JE, Worthington JJ et al. Body dysmorphic disorder in outpatients with major depression. Journal of Affective Disorders. 2002;69(1-3):141-148. https://doi.org/10.1016/S0165-0327(01)00304-4
Nierenberg, Andrew A. ; Phillips, Katharine A. ; Petersen, Timothy J. ; Kelly, Karen E. ; Alpert, Jonathan E. ; Worthington, John J. ; Tedlow, Joyce R. ; Rosenbaum, Jerrold F. ; Fava, Maurizio. / Body dysmorphic disorder in outpatients with major depression. In: Journal of Affective Disorders. 2002 ; Vol. 69, No. 1-3. pp. 141-148.
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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{\%}; χ2=6.63; P=0.01: 11.6{\%} vs. 4.1{\%}; χ2=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. Limitations: 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.",
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KW - Axis I comorbidity

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