نگرانی وزن در افراد مبتلا به اختلال بدریخت انگاری

Objective To determine the prevalence of weight concerns in individuals with BDD, and to examine similarities and differences between those with and those without weight concerns. Method We assessed 200 participants with BDD for clinically significant weight concerns and compared those with weight concerns (in addition to other body area concerns) to those without weight concerns on measures of BDD symptoms, other symptom severity, comorbidity, suicidality, functioning, and quality of life. Results 58 (29.0%) participants had weight concerns. Participants with weight concerns were younger, more likely to be female, and had more body areas of concern; a higher frequency of certain BDD behaviors, suicide attempts, and comorbidity; greater body image disturbance and depression; and poorer social functioning. The two groups were similar on other measures. Discussion Weight concerns in BDD deserve further study, as they appear relatively common and are associated with greater symptom severity and psychopathology in several domains.

Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance (American Psychiatric Association, 2000), appears to usually focus on the face or head (Phillips, McElroy, Keck, Pope, & Hudson, 1993; Veale et al., 1996). Indeed, early reports on BDD's clinical features did not include any individuals with clinically significant weight concerns (Phillips et al., 1993 and Veale et al., 1996). However, more recent reports have included such individuals (Rosen et al., 1995 and Veale et al., 2003). Patients with weight concerns have been hypothesized to be a less impaired group of BDD sufferers (Veale, Kinderman, Riley, & Lambrou, 2003), although few studies have directly compared them to BDD patients with non-weight concerns. In one study (Veale et al., 2003), individuals with BDD who were mainly preoccupied with their weight (n = 35) had similar levels of depression and social anxiety as did BDD participants without weight preoccupations (n = 72). BDD participants with weight concerns were also more depressed and socially anxious than nonclinical controls (n = 42). In a study of adolescent psychiatric inpatients ( Dyl, Kittler, Phillips, & Hunt, in press), those who met criteria for BDD but were primarily concerned with their weight did not differ from those with non-weight-related BDD; both groups had more severe depression, anxiety, and suicidal ideation than psychiatric inpatients without BDD. Despite these two studies, the clinical characteristics of those with clinically significant weight-related preoccupations, as compared to those with non-weight-related BDD, remain largely unexplored. This is a critical area of research, given uncertainty regarding the correct diagnosis (e.g., EDNOS vs. BDD) and treatment of individuals who endorse significant weight-related preoccupations but do not meet criteria for anorexia or bulimia nervosa ( Grant and Phillips, 2004).