The nature of body dysmorphic disorder is that someone is suffering because of their perceived (not objective) flaws in appearance. I didn’t understand how much people suffer, and the potential severity of this disorder, until I covered a talk by Dr. Katharine A. Phillips at the annual meeting of the American College of Psychiatrists.
It goes beyond suffering. Body dysmorphic disorder can be life-threatening. Patients have been known to pick at a “blemish” on their skin so obsessively that they dig down to an artery, and need emergency surgery to stop the bleeding.
The psychological distress is so severe that 24%-28% of people with body dysmorphic disorder try to kill themselves. And many succeed. Dr. Phillips said she has preliminary data suggesting that the annual rate of completed suicides is 22-36 times higher among people with body dysmorphic disorder compared with the general population.
This is not a rare disorder. Its prevalence has been reported as approximately 2% in nationwide epidemiologic studies, or 2%-13% in nonclinical student samples. Students? Yes — body dysmorphic disorder most commonly first appears at 13 years of age. And not just in females. Males may be as likely to develop body dysmorphic disorder, typically thinking they are too small or thin (one factor behind the dangerous use of steroids).
See my full report on Dr. Phillip’s talk soon in Clinical Psychiatry News. In the meantime, if you’re a clinician doing cognitive behavioral therapy with patients who have body dysmorphic disorder, Dr. Phillips strongly recommends a book for you to have and read: “Cognitive Therapy for Suicidal Patients: Scientific and Clinical Applications” (American Psychological Association, 2008).
— Sherry Boschert (@sherryboschert on Twitter)