Document Detail


A sociodemographic, phenomenological, and long-term follow-up study of patients with body dysmorphic disorder in Brazil.
MedLine Citation:
PMID:  17154152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The main characteristic of body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance in a normal-appearing person or an excessive preoccupation with appearance in a person with a small physical defect. In this non-controlled study, our objective was to describe the socio-demographic, phenomenological, and long-term outcome features of a Brazilian sample of patients with BDD. METHODS: We performed a chart-review of the 166 patients who attended the Obsessions, Compulsions, and Impulsions Subprogram of the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, during the period between 1998 and 2005. RESULTS: Twenty patients (12%) had clinically significant BDD. This sample was characterized by a predominance of female (n = 11; 55%), single or divorced (n = 18; 90%), and economically unproductive patients (n = 17; 85%). We found an average of 2.5 current imagined defects per patient. The most frequently reported body parts of excessive concern were the overall appearance, size or shape of the face (n = 7; 35%), the skin (n = 6; 30%), the hair (n = 6; 30%), the nose (n = 5; 25%), and the body build and weight (n = 5; 25%). Most individuals exhibited a chronic condition (n = 13; 65%) and kept the same concerns during the course of the disorder (n = 12; 60%). All patients displayed compulsive behaviors, including recurrent mirror checking (n = 14; 70%), camouflaging (n = 13; 65%), reassurance seeking by means of repetitive questioning of others (n = 9; 45%), and excessive use of cosmetics (n = 7; 35%). Two patients reported "do-it-yourself" surgeries. Seven patients had current suicidal ideation (35%). Six patients (30%) showed no insight over their dysmorphic beliefs. Fifteen patients (95%) exhibited psychiatric comorbidities, mostly obsessive-compulsive disorder (OCD) (n = 14, 70%) and major depressive disorder (n = 11; 55%). The majority of patients were treated naturalistically with serotonin reuptake inhibitors (n = 15; 75%), either solo or in association with antipsychotics (n = 10; 50%). Nevertheless, only 5 (25%) responded favorably to treatment during the long-term follow-up (CGI < or = 2). CONCLUSIONS: BDD is a severe disorder that is frequently associated with other psychiatric conditions and responds poorly to treatment in the naturalistic setting. No significant trans-cultural variations were identified in the comparison between Brazilian, North American, and European samples.
Authors:
Leonardo F Fontenelle; Leonardo L Telles; Bruno P Nazar; Gabriela Bezerra de Menezes; Antonio Leandro do Nascimento; Mauro V Mendlowicz; Marcio Versiani
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of psychiatry in medicine     Volume:  36     ISSN:  0091-2174     ISO Abbreviation:  Int J Psychiatry Med     Publication Date:  2006  
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365646     Medline TA:  Int J Psychiatry Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-59     Citation Subset:  IM    
Affiliation:
Federal University of Rio de Janeiro, Brazil. lfontenelle@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Brazil
Chronic Disease
Comorbidity
Compulsive Behavior / diagnosis,  epidemiology,  psychology
Cross-Cultural Comparison
Cross-Sectional Studies
Depressive Disorder, Major / diagnosis,  epidemiology,  psychology
Follow-Up Studies
Humans
Obsessive-Compulsive Disorder / diagnosis,  epidemiology,  psychology
Retrospective Studies
Socioeconomic Factors*
Somatoform Disorders / diagnosis,  epidemiology*,  psychology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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