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Cited by 245Body Image and Dysmorphia StudiesPsychosomatic Disorders and Their TreatmentsObsessive-Compulsive Spectrum Disorders

Age at onset and clinical correlates in body dysmorphic disorder

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Bjornsson, Andri S., Didie, Elizabeth R., Grant, Jon E., Menard, William, Stalker, Emily, Phillips, Katharine A.·2013·Comprehensive Psychiatry
DOI 10.1016/j.comppsych.2013.03.019PMC PMC3779493
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Abstract

Objective Age at onset is an important clinical feature of all disorders. However, no prior studies have focused on this important construct in body dysmorphic disorder (BDD). In addition, across a number of psychiatric disorders, early age at disorder onset is associated with greater illness severity and greater comorbidity with other disorders. However, clinical correlates of age at onset have not been previously studied in BDD.Methods Age at onset and other variables of interest were assessed in two samples of adults with DSM-IV BDD; sample 1 consisted of 184 adult participants in a study of the course of BDD, and sample 2 consisted of 244 adults seeking consultation or treatment for BDD. Reliable and valid measures were used. Subjects with early-onset BDD (age 17 or younger) were compared to those with late-onset BDD.Results BDD had a mean age at onset of 16.7 (SD=7.3) in sample 1 and 16.7 (SD=7.2) in sample 2. 66.3% of subjects in sample 1 and 67.2% in sample 2 had BDD onset before age 18. A higher proportion of females had early-onset BDD in sample 1 but not in sample 2. On one of three measures in sample 1, those with early-onset BDD currently had more severe BDD symptoms. Individuals with early-onset BDD were more likely to have attempted suicide in both samples and to have attempted suicide due to BDD in sample 2. Early age at BDD onset was associated with a history of physical violence due to BDD and psychiatric hospitalization in sample 2. Those with early-onset BDD were more likely to report a gradual onset of BDD than those with late-onset in both samples. Participants with early-onset BDD had a greater number of lifetime comorbid disorders on both Axis I and Axis II in sample 1 but not in sample 2. More specifically, those with early-onset BDD were more likely to have a lifetime eating disorder (anorexia nervosa or bulimia nervosa) in both samples, a lifetime substance use disorder (both alcohol and non-alcohol) and borderline personality disorder in sample 1, and a lifetime anxiety disorder and social phobia in sample 2.Conclusions BDD usually began during childhood or adolescence. Early onset was associated with gradual onset, a lifetime history of attempted suicide, and greater comorbidity in both samples. Other clinical features reflecting greater morbidity were also more common in the early-onset group, although these findings were not consistent across the two samples.

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  • A BDD általában serdülőkorban kezdődik, az esetek kétharmadában 18 éves kor előtt (átlagosan 16,7 éves korban), és a korai kezdet általában súlyosabb lefolyással jár.

    “A BDD általában serdül ő korban kezd ő dik, az esetek kétharmadában 18 éves kor el ő tt (átlagosan 16,7 éves korban), a korai kezdet általában súlyosabb lefolyással jár (Bjornsson, Didie, Grant, Menard, Stalker és Phillips, 2013; Veale és mtsai, 2016).”

    From A testdiszmorfiás zavar pszichológiai vonatkozásai (2023) · cites this paper as Bjornsson, Didie, Grant, Menard, Stalker és Phillips, 2013

    The Results and Discussion report a mean onset age of 16.7 years in both samples, with about two-thirds developing BDD before age 18. Early onset was associated with suicide attempts and some other indicators of greater morbidity, but the Discussion says early- and late-onset groups were generally similar in BDD symptom severity, functioning, and quality of life. Thus, the claim that early onset generally entails a more severe course is too broad. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Approximately 70% of patients report symptom onset during adolescence.

    “Since approximately 70% of patients report symptom onset during adolescence (Bjornsson et al., 2013), further trials are warranted in this age group, preferably in the incipient phases of the disorder, with the aim of preventing school failure, suicide risk, and chronicity.”

    From Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials (2016) · cites this paper as Bjornsson et al., 2013

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Research works printed but not linked: 2

  1. [59]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV-TR Axis I disorders, research version, patient edition (SCID-I/P) New York Biometrics Research 2002
  2. [61]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV Axis I disorders: Non-patient edition (SCID-N/P) New York New York State Psychiatric Institute 1996

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Authors
Bjornsson, A. S., Didie, E. R., Grant, J. E., Menard, W., Stalker, E., & Phillips, K. A.
Affiliations
  • University of Iceland (IS)
  • Brown University (US)
  • University of Minnesota (US)
  • Rhode Island Hospital (US)
  • Dickinson College (US)
Corresponding author
Bjornsson, Andri S.
ORCID
Venue
Comprehensive Psychiatry
Publisher
Elsevier BV
Published
2013-10
Volume
54
Issue
7
Pages
893-903
ISSN
0010-440X (ISSN-L)
DOI
10.1016/j.comppsych.2013.03.019
PMC
PMC3779493
OpenAlex
W1976715497
Cited by
245
References
91
Citations by year
2026: 18 · 2025: 19 · 2024: 26 · 2023: 23 · 2022: 14 · 2021: 27 · 2020: 20 · 2019: 19 · 2018: 17 · 2017: 18 · 2016: 13 · 2015: 25 · 2014: 6
FWCI
16.17
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Comprehensive Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
National Institute of Mental Health (R01MH060241, K24MH063975)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords
body dysmorphic disorder, age of onset, suicide attempts, comorbidities, eating disorders, substance use disorders, borderline personality disorder, anxiety disorders, social anxiety disorder, disease severity, clinical course, gender differences, childhood onset, physical violence, psychiatric hospitalization, gradual onset, DSM-IV diagnostic criteria
MeSH terms
Adolescent, Adult, Anxiety Disorders, Female, Humans, Personality Disorders, Severity of Illness Index, Suicide, Attempted, Comorbidity, Age of Onset, Substance-Related Disorders, Body Dysmorphic Disorders

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