S E Marron1,2,3, A Miranda-Sivelo3,4, L Tomas-Aragones2,3,5, C Rodriguez-Cerdeira3,6, M J Tribo-Boixaro3,7, M Garcia-Bustinduy3,8, T Gracia-Cazaña2,3,9, S Ros-Abarca3,10, E Roe-Crespo10, R M Diaz-Díaz3,11, C Brufau-Redondo3,12, M C Martinez-Gonzalez3,13, A Guerra-Tapia3,14, E González-Guerra3,15, L Puig10. 1. Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain. 2. Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain. 3. Spanish Research Group of Dermatology and Psychiatry (GEDEPSI) of the Spanish Academy of Dermatology and Venereology (AEDV), Madrid, Spain. 4. Department of Psychiatry, General Hospital of Segovia, Segovia, Spain. 5. Department of Psychology, University of Zaragoza, Zaragoza, Spain. 6. Department of Dermatology, University Hospital of Vigo, Vigo, Spain. 7. Department of Dermatology, Hospital del Mar, Barcelona, Spain. 8. Department of Dermatology, University Hospital of Canary Island, Santa Cruz de Tenerife, Spain. 9. Department of Dermatology, Barbastro Hospital, Barbastro, Spain. 10. Department of Dermatology, Sant Pau Hospital, Barcelona, Spain. 11. Dermatology Department, Infanta Sofía Hospital, San Sebastián de los Reyes, Madrid, Spain. 12. Department of Dermatology, University Hospital Reina Sofía, Murcia, Spain. 13. Private Clinic of Dermatology, Oviedo, Spain. 14. Department of Dermatology, 12 de Octubre Hospital, Madrid, Spain. 15. Department of Dermatology, University Hospital San Carlos, Madrid, Spain.
Abstract
BACKGROUND AND OBJECTIVE: Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM-IV and DSM-5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. METHODS: A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. RESULTS: In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6-13.6%). The prevalence was the same with DSM-IV or DSM-5 criteria. Possible cases of BDD were predominantly women (P = 0.021), and 56% had non-inflammatory lesions vs. 30% of negative patients (P = 0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make-up (72.1%). CONCLUSIONS: As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.
BACKGROUND AND OBJECTIVE:Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM-IV and DSM-5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. METHODS: A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. RESULTS: In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6-13.6%). The prevalence was the same with DSM-IV or DSM-5 criteria. Possible cases of BDD were predominantly women (P = 0.021), and 56% had non-inflammatory lesions vs. 30% of negative patients (P = 0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make-up (72.1%). CONCLUSIONS: As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.