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A 4-year prospective observational follow-up study of course and predictors of course in body dysmorphic disorder

Published online by Cambridge University Press:  29 August 2012

K. A. Phillips ,
W. Menard ,
E. Quinn ,
E. R. Didie  and
R. L. Stout
K. A. Phillips*
Affiliation:
Rhode Island Hospital, Providence, RI, USA Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
W. Menard
Affiliation:
Rhode Island Hospital, Providence, RI, USA
E. Quinn
Affiliation:
Stonehill College, Easton, MA, USA
E. R. Didie
Affiliation:
Rhode Island Hospital, Providence, RI, USA Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
R. L. Stout
Affiliation:
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA Pacific Institute for Research and Evaluation, Calverton, MD, USA
*
*Address for correspondence: K. A. Phillips, M.D., Rhode Island Hospital, Coro Center West, Suite 2.030, 1 Hoppin Street, Providence, RI 02903, USA. (Email: [email protected])
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Abstract

Background

This report prospectively examines the 4-year course, and predictors of course, of body dysmorphic disorder (BDD), a common and often severe disorder. No prior studies have prospectively examined the course of BDD in individuals ascertained for BDD.

Method

The Longitudinal Interval Follow-Up Evaluation (LIFE) assessed weekly BDD symptoms and treatment received over 4 years for 166 broadly ascertained adults and adolescents with current BDD at intake. Kaplan–Meier life tables were constructed for time to remission and relapse. Full remission was defined as minimal or no BDD symptoms, and partial remission as less than full DSM-IV criteria, for at least 8 consecutive weeks. Full relapse and partial relapse were defined as meeting full BDD criteria for at least 2 consecutive weeks after attaining full or partial remission respectively. Cox proportional hazards regression examined predictors of remission and relapse.

Results

Over 4 years, the cumulative probability was 0.20 for full remission and 0.55 for full or partial remission from BDD. A lower likelihood of full or partial remission was predicted by more severe BDD symptoms at intake, longer lifetime duration of BDD, and being an adult. Among partially or fully remitted subjects, the cumulative probability was 0.42 for subsequent full relapse and 0.63 for subsequent full or partial relapse. More severe BDD at intake and earlier age at BDD onset predicted full or partial relapse. Eighty-eight percent of subjects received mental health treatment during the follow-up period.

Conclusions

In this observational study, BDD tended to be chronic. Several intake variables predicted greater chronicity of BDD.

Keywords

Body dysmorphic disordercoursepredictorsrelapseremission
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 5 , May 2013 , pp. 1109 - 1117
Copyright
Copyright © Cambridge University Press 2012

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