The goal of this proposal is to investigate prospectively the course of body dysmorphic disorder (BDD) and its delusional disorder variant in 200 adults and adolescents over 3 to 4 years. Body dysmorphic disorder, an often-delusional preoccupation with an imagined or slight defect in appearance, is a distressing, impairing, and costly disorder that is more common than is generally recognized. Such investigation is important because BDD appears to often be chronic and to cause considerable morbidity over the life span. It is associated with high rates of social and academic/occupational impairment, being housebound, psychiatric hospitalization, suicidal ideation, and suicide attempts. Only minimal data are available on the longitudinal course and outcome of BDD. Thus, little is known about the clinical course of symptom severity, psychosocial functioning, and quality of life. This proposal's broad objective is to conduct the first prospective longitudinal study of the course and outcome of BDD and its delusional variant (delusional disorder, somatic type).
The specific aims are the following: 1) map patterns of course for BDD; 2) identify predictors/mediating variables associated with remission and relapse; 3) describe surgical, dermatologic, other medical, and psychiatric treatment received, and examine the association between treatment and course; and 4) describe psychosocial functioning and quality of life over time, and assess their relationship with BDD symptom severity and delusionality. Subjects will be carefully evaluated at annual intervals with reliable and valid instruments that obtain detailed information on symptom status and severity, diagnostic status, treatment utilization, psychosocial functioning, quality of life and other domains. The proposed study will be the first prospective study of the course of BDD. Findings from the study will shed new light on clinically and theoretically important questions about a severe and relatively common, yet underrecognized and understudied, disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH060241-03
Application #
6528579
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Cuthbert, Bruce N
Project Start
2000-09-15
Project End
2005-08-31
Budget Start
2002-09-01
Budget End
2003-08-31
Support Year
3
Fiscal Year
2002
Total Cost
$279,473
Indirect Cost
Name
Butler Hospital (Providence, RI)
Department
Type
DUNS #
069847804
City
Providence
State
RI
Country
United States
Zip Code
02906
Kelly, Megan M; Didie, Elizabeth R; Phillips, Katharine A (2014) Personal and appearance-based rejection sensitivity in body dysmorphic disorder. Body Image 11:260-5
Bjornsson, Andri S; Didie, Elizabeth R; Grant, Jon E et al. (2013) Age at onset and clinical correlates in body dysmorphic disorder. Compr Psychiatry 54:893-903
Hart, Ashley S; Phillips, Katharine A (2013) Symmetry Concerns as a Symptom of Body Dysmorphic Disorder. J Obsessive Compuls Relat Disord 2:292-298
Phillips, Katharine A; Hart, Ashley S; Menard, William et al. (2013) Psychometric evaluation of the Brown Assessment of Beliefs Scale in body dysmorphic disorder. J Nerv Ment Dis 201:640-3
Phillips, K A; Menard, W; Quinn, E et al. (2013) A 4-year prospective observational follow-up study of course and predictors of course in body dysmorphic disorder. Psychol Med 43:1109-17
Phillips, Katharine A; Menard, William; Bjornsson, Andri S (2013) Cued panic attacks in body dysmorphic disorder. J Psychiatr Pract 19:194-203
Kelly, Megan M; Dalrymple, Kristy; Zimmerman, Mark et al. (2013) A comparison study of body dysmorphic disorder versus social phobia. Psychiatry Res 205:109-16
Phillips, Katharine A; Pinto, Anthony; Hart, Ashley S et al. (2012) A comparison of insight in body dysmorphic disorder and obsessive-compulsive disorder. J Psychiatr Res 46:1293-9
Didie, Elizabeth R; Loerke, Elizabeth H; Howes, Sarah E et al. (2012) Severity of interpersonal problems in individuals with body dysmorphic disorder. J Pers Disord 26:345-56
Phillips, Katharine A; Stein, Dan J; Rauch, Scott L et al. (2010) Should an obsessive-compulsive spectrum grouping of disorders be included in DSM-V? Depress Anxiety 27:528-55

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