Body dysmorphic disorder (BDD) symptoms are more prevalent for patients with dermatological conditions compared with healthy-skin controls, according to a study published online Jan. 18 in the British Journal of Dermatology .

Christina Schut, Ph.D., from the Justus-Liebig-University Gießen in Germany, and colleagues compared the prevalence of BDD symptoms between patients with different dermatological conditions and healthy-skin controls in a cross-sectional multicenter study involving 5,487 patients with different skin diseases, recruited at 22 dermatology outpatient clinics, and 2,808 healthy-skin controls.

The researchers found that the prevalence of BDD symptoms was five times higher for patients with dermatological conditions compared with healthy-skin controls (10.5 versus 2.1 percent). The odds of having BDD symptoms were elevated more than 11-fold for patients with hyperhidrosis, alopecia, and vitiligo compared with healthy-skin controls (adjusted odds ratio, >11), while the odds were increased more than sixfold for patients with atopic dermatitis, psoriasis, acne, hidradenitis suppurativa, prurigo, and bullous diseases (adjusted odds ratio, >6). BDD symptoms were significantly associated with younger age, female sex, higher psychological stress, and feelings of stigmatization using a logistic regression model.

"This study demonstrated that more than 10 percent of patients with dermatological conditions experience potentially distressing symptoms of BDD," the authors write. "This highlights that doctors should keep in mind this condition and refer patients not responding to treatment to an appropriate health care service for further psychological assessment."

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