یک مطالعه گذشته نگر پیگیری اختلال بدریخت انگاری

Background Although research on body dysmorphic disorder (BDD) is increasing, no follow-up studies of this disorder's course of illness have been published. Methods The status of 95 outpatients with BDD treated in a clinical practice was assessed by chart review. Standard scales were used to rate subjects at baseline and the most recent clinic visit (mean duration of follow-up, 1.7 ± 1.1; range, 0.5-6.4 years). Ratings were also done at 6-month intervals over the first 4 years of follow-up. Results Allowing for censoring, life table analysis estimated that the proportion of subjects who achieved full remission from BDD at the 6-month and/or 12-month assessment was 24.7%; the proportion who attained partial or full remission at 6 months and/or 12 months was 57.8%. After 4 years of follow-up, 58.2% had experienced full remission, and 83.8% had experienced partial or full remission, at one or more 6-month assessment points. Of those subjects who attained partial or full remission at one or more assessment points, 28.6% subsequently relapsed. Between baseline and the most recent assessment, BDD severity and functioning significantly improved: at the most recent assessment, 16.7% of subjects were in full remission, 37.8% were in partial remission, and 45.6% met full criteria for BDD. Greater severity of BDD symptoms and the presence of major depression or social phobia at baseline were associated with more severe BDD symptoms at study end point. All subjects received at least one medication trial, and 34.3% received some type of therapy during the follow-up period. Conclusions A majority of treated patients with BDD improved, although improvement was usually partial. Prospective longitudinal studies are needed to further elucidate the course of BDD.

Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, is a relatively common disorder [1] and [2]. It is associated with high rates of functional impairment and suicide attempts [3] and [4], high levels of perceived stress [5], and markedly poor quality of life [6] and [7]. Although research on BDD is rapidly increasing, this disorder's course of illness has received virtually no investigation. Available data are from case reports [8], which generally report a chronic course, and 2 studies (n = 188 and n = 200) that asked subjects to retrospectively describe the past course of their BDD symptoms [9] and [10]. These 2 studies reported a similar mean duration of BDD: 15.7 ± 11.9 years (range, 1-69 years) in one study [9] and 15.8 ± 12.3 years (range, 1-51 years) [10] in the other. Both studies also retrospectively reported a chronic course of BDD symptoms (ie, less than 1 month of remission since onset) in a majority of cases (82% [9] and 81% [10]) as well as a generally worsening course over time (in 61% [9] and 53% [10] of patients). In these studies, information on illness course was limited to these few questions, standard measures were not used to assess course, and all information on course of illness was obtained retrospectively.