Body dysmorphic disorder (BDD) is characterised by a preoccupation with perceived defects in one's appearance, which leads to significant distress and/or impairment. Although several studies have investigated the prevalence of BDD, many studies have methodological limitations (e.g., small sample sizes and student populations), and studies on the prevalence of BDD in the general population are limited. In the current study, 2510 individuals participated in a representative German nationwide survey. Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for BDD and associated characteristics such as suicidality and the prevalence of plastic surgeries were examined using self-report questionnaires. The prevalence of current BDD was 1.8% (N = 45). Further, individuals with BDD, relative to individuals without BDD, reported significantly more often a history of cosmetic surgery (15.6% vs. 3.0%), higher rates of suicidal ideation (31.0% vs. 3.5%) and suicide attempts due to appearance concerns (22.2% vs. 2.1%). The current findings are consistent with previous findings, indicating that self-reported BDD is a common disorder associated with significant morbidity.
Individuals with body dysmorphic disorder (BDD) are distressed about perceived flaws in their physical appearance, commonly in their face (e.g., wrinkles, size or shape of the nose or ears; American Psychiatric Association [APA], 2000). Although these “defects” are usually not noticeable to others, individuals with BDD misperceive their body part(s) of concern as unattractive and repulsive and often spend several hours per day worrying about their appearance. They frequently engage in time-consuming repetitive behaviours such as comparing, mirror checking, camouflaging, excessive grooming or reassurance seeking (e.g., Phillips et al., 1993 and Phillips, 1991). Further, BDD is associated with significant morbidity, including social or occupational impairment, being housebound, hospitalisation and suicide attempts (e.g., Phillips and Menard, 2006 and Phillips et al., 1993).
Despite increased awareness of BDD in the last decade, it is a relatively unknown and under-studied disorder. Although some studies have examined the prevalence of BDD, the obtained rates vary widely, which may be due to methodological differences and limitations (e.g., nonrepresentative populations and small sample sizes). Studies examining prevalence rates in student populations, in which higher base rates might be expected, have obtained prevalence rates of self-reported BDD ranging from 5% (Cansever et al., 2003, N = 420 female nursing school students; Bohne et al., 2002, N = 133 psychology students;) to 13% ( Biby, 1998, N = 102 psychology students). A few studies examined the prevalence of BDD using structured clinical interviews ( Otto et al., 2001, Bienvenu et al., 2000 and Faravelli et al., 1997). Specifically, Otto et al. (2001) reported a BDD prevalence rate of 0.7% in a sample of 658 nondepressed and 318 depressed women between 36 and 44 years of age. Faravelli and colleagues examined the prevalence of BDD in 637 subjects from the general population of Tuscany (Italy) and also obtained a prevalence of 0.7% ( Faravelli et al., 1997). In addition, Bienvenu et al. (2000) found a BDD prevalence of 3% in a small community sample (N = 73). Taken together, these results suggest that BDD prevalence rates vary significantly depending on the subject population, sample size and assessment methods.
