Body dysmorphic disorder is not a trivial illness, Katharine Phillips,
M.D., a professor of psychiatry at Brown University and a body dysmorphic
disorder authority, stressed during a recent interview.
"My clinical experience suggests that patients with the illness
suffer tremendously and are often suicidal and seriously ill," she
In addition, she pointed out, "the disorder appears to be relatively
common, yet very little systematic research has been conducted on it."
Thus, a decade or so ago, she decided to start studying it herself, learning,
among other things, that the SSRI antidepressants can improve daily
functioning in people with the disorder (Psychiatric News, October
And now Phillips, along with Robert Stout, Ph.D., also a professor of
psychiatry at Brown, has conducted a study to examine longitudinal
associations between the disorder and three mental illnesses that often
accompany it—major depression, obsessive-compulsive disorder (OCD), and
For one to three years, they followed the clinical outcomes of 161 subjects
who had body dysmorphic disorder and one of three other disorders: 37 percent
had a major depressive disorder, 33 percent had social phobia, and 26 percent
Improvement in body dysmorphic disorder and major depression often occurred
hand in hand, the researchers found, with improvement of each disorder
significantly predicting remission of the other.
"I thought we would see improvement in body dysmorphic disorder
predicting major depressive disorder remission," Phillips said,"
but I didn't know what we would find regarding the converse."
As for body dysmorphic disorder and OCD, improvement in OCD significantly
predicted remission of body dysmorphic disorder, but not vice versa.
With regard to body dysmorphic disorder and social phobia, improvement in
one did not significantly predict remission of the other.
Thus, body dysmorphic disorder seems to be closely related to major
depression, somewhat related to OCD, and not related to social phobia,
Phillips and Stout concluded in their study report, which is in press with the
Journal of Psychiatric Research. Nonetheless, they wrote,"
Family, twin, and adoption studies, and—most
important—studies of etiology and pathophysiology are needed to
elucidate the nature of the disorders' relationship to one another."
Furthermore, they stressed, body dysmorphic disorder does not appear to be
simply an expression of major depression or OCD because body dysmorphic
disorder persisted in more than half of subjects who remitted from the two
The study was funded by the National Institute of Mental Health.
An abstract of "Associations in the Longitudinal Course of
Body Dysmorphic Disorder With Major Depression, Obsessive-Compulsive Disorder,
and Social Phobia" can be accessed at<www.sciencedirect.com>
by clicking on "Browse A-Z of journals," "J," the"
Journal of Psychiatric Research," and "Articles in