Dissociative and Somatoform Disorders 371
Table 8.17 • Body Dysmorphic Disorder Facts at a Glance
Prevalence- Approximately 0.7–2.3% of the general population has body dysmorphic disorder at any given time (Otto
et al., 2001; Phillips, 2001). - Among people having plastic surgery or dermatological treatment, prevalence rates range from 6% to 15%
(Phillips, 2001).
Comorbidity- Up to 60% of people with body dysmorphic disorder are also depressed; body dysmorphic disorder usually
emerges fi rst (Otto et al., 2001; Phillips, 2001). - Thirty-eight percent of people with body dysmorphic disorder may also have social phobia (Coles et al.,
2006). - Up to 30% of people with body dysmorphic disorder also have OCD (Phillips, 2001).
- In one survey, almost half of those with body dysmorphic disorder had (at the time or previously) a sub-
stance-use disorder (Grant et al., 2005). - Almost a third of those with body dysmorphic disorder will also develop an eating disorder (Ruffolo et al.,
2006).
Onset- Body dysmorphic disorder usually begins in adolescence (Phillips & Diaz, 1997; Phillips, Menard, et al.,
2005), but it can go undiagnosed for several years if the person does not discuss the symptoms with anyone.
Course- Body dysmorphic disorder is generally chronic, with fewer remissions than depression or most anxiety disor-
ders (Phillips, Pagano et al., 2005, 2006; Phillips, Quinn, & Stout, 2008). - The intensity of symptoms may ebb and fl ow (Phillips & Diaz, 1997).
- Over 25% of adults with body dysmorphic disorder have been housebound for at least 1 week; 8% were
unable to work and received disability payments (Albertini & Phillips, 1999; Phillips et al., 1994). - Two surveys found that about 30% of people with body dysmorphic disorder had attempted suicide (Phillips
et al., 1994; Phillips, Coles, et al., 2005).
Gender Differences- Body dysmorphic disorder affects both genders with approximately equal frequency, but men and women
tend to differ with regard to the specifi c body parts they view as defective (Phillips, Menard, & Fay, 2006):
Women are preoccupied with body weight, hips, breasts, and legs, and are more likely to pick their skin
compulsively. In contrast, men are preoccupied with body build, genitals, height, excessive body hair, and
thinning scalp hair, and are more likely to abuse or be dependent on alcohol. - A variant of body dysmorphic disorder has been documented in some men who use anabolic steroids to build
up their perceived weak muscles (Phillips, 2001).
Cultural Differences- Generally, symptoms of body dysmorphic disorder are similar across cultures, although certain body attri-
butes may be more likely to be the focus of concern, depending on what physical attributes are valued in a
given culture (Pope et al., 1997, 2000).
with koro are preoccupied with their penis (in men) or labia, nipples, or breasts
(in women), and fear that those body parts are shrinking or retracting and will
disappear into their bodies, possibly resulting in death. In contrast to body dysmor-
phic disorder, koro is usually brief and symptoms disappear after reassurance.
Diagnosing Body Dysmorphic Disorder Versus Other Disorders
If some of the descriptions of the symptoms of body dysmorphic disorder seem
to you to resemble those of anxiety disorders, you’re right. Body dysmorphic