عملکرد شغلی و اختلال در بزرگسالان مبتلا به اختلال بدریخت انگاری

Body dysmorphic disorder (BDD) is relatively common and appears to be associated with marked impairment in psychosocial functioning. Previous reports, however, did not investigate occupational functioning in detail, assess impairment specifically in occupational functioning using standardized measures in a nontreatment seeking sample, or examine correlates of occupational impairment. Methods Occupational functioning and other clinical variables were assessed in 141 adults with BDD. Measures included the Range of Impaired Functioning Tool and other reliable and valid self-report and interviewer-administered measures. Results Fewer than half of subjects were working full-time, and 22.7% were receiving disability pay. Thirty-nine percent of the sample reported not working in the past month because of psychopathology. Of those subjects who worked in the past month, 79.7% reported impairment in work functioning because of psychopathology. Adults with BDD who were not working because of psychopathology were comparable to subjects who were working in most demographic variables, delusionality of BDD beliefs, and duration of BDD. However, compared to subjects who worked in the past month, those not currently working because of psychopathology had more severe BDD and more chronic BDD. They also were more likely to be male, had less education, and had more severe depressive symptoms, a higher rate of certain comorbid disorders, poorer current social functioning and quality of life, a higher rate of lifetime suicidality, and were more likely to have been psychiatrically hospitalized. Conclusions A high proportion of individuals with BDD were unable to work because of psychopathology; most who worked reported impairment in occupational functioning. Certain clinical variables, including more severe and chronic BDD, were associated with not working.

Body dysmorphic disorder (BDD) is defined in the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) as a distressing or impairing preoccupation with an imagined or slight defect in appearance. This disorder appears to be relatively common, with a reported prevalence of 0.7% to 1.7% in community or general population samples [1], [2], [3] and [4]. Body dysmorphic disorder is associated with high lifetime rates of psychiatric hospitalization, suicidal ideation and suicide attempts, and markedly poor social functioning and quality of life [5], [6], [7], [8], [9] and [10]. Impairment in occupational functioning also appears common. In a study of 188 subjects with BDD from the United States, 38% were currently unemployed, and 77% reported that their BDD symptoms had interfered moderately, severely, or extremely with occupational, academic, or role functioning over the course of their illness [7]. In a study from England [8], 50% of 50 subjects with BDD were currently unemployed; in 2 studies from Italy, 53% of 58 subjects with BDD and 47% of 34 subjects with BDD were currently unemployed [11] and [12]; and in a study from Brazil, 85% of 20 subjects with BDD were currently unemployed [13]. Despite these unemployment rates and indications of occupational impairment, these studies did not specifically assess problems in occupational functioning using standardized measures that examine this domain specifically, nor did they examine correlates of occupational impairment.