Grant Jon E, Kim Suck Won, Eckert Elke D
Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA.
Int J Eat Disord. 2002 Nov;32(3):291-300. doi: 10.1002/eat.10091.
The prevalence of body dysmorphic disorder in patients with anorexia nervosa is unknown. We hypothesized that body dysmorphic disorder would be underdiagnosed in patients with anorexia nervosa and that comorbidity with body dysmorphic disorder would result in greater overall dysfunction.
Forty-one patients with DSM-IV anorexia nervosa completed the Body Dysmorphic Disorder Questionnaire, a self-report screen for body dysmorphic disorder. A follow-up interview was conducted using a reliable clinician-administered semistructured diagnostic instrument for DSM-IV body dysmorphic disorder. Delusionality about appearance was assessed using a validated semistructured interview. Comorbid DSM-IV diagnoses, number of hospitalizations and suicide attempts were obtained by means of a detailed diagnostic interview.
Sixteen (39%) of the 41 patients with anorexia nervosa were diagnosed with comorbid body dysmorphic disorder unrelated to weight concerns. The anorexia nervosa patients with body dysmorphic disorder had significantly lower overall functioning and higher levels of delusionality than the anorexic patients without body dysmorphic disorder.
These preliminary results suggest that body dysmorphic disorder may be relatively common among patients with anorexia nervosa. The presence of comorbid body dysmorphic disorder may indicate a more severe form of illness.
神经性厌食症患者中身体变形障碍的患病率尚不清楚。我们假设神经性厌食症患者中身体变形障碍可能未得到充分诊断，且身体变形障碍的共病会导致更严重的整体功能障碍。
41名符合《精神疾病诊断与统计手册》第四版（DSM-IV）标准的神经性厌食症患者完成了身体变形障碍问卷，这是一种用于筛查身体变形障碍的自我报告量表。采用一种可靠的、由临床医生实施的针对DSM-IV身体变形障碍的半结构化诊断工具进行随访访谈。使用经过验证的半结构化访谈评估对外表的妄想。通过详细的诊断访谈获取共病的DSM-IV诊断、住院次数和自杀未遂次数。
41名神经性厌食症患者中有16名（39%）被诊断为与体重问题无关的共病身体变形障碍。与无身体变形障碍的神经性厌食症患者相比，患有身体变形障碍的神经性厌食症患者整体功能显著更低，妄想水平更高。
这些初步结果表明，身体变形障碍在神经性厌食症患者中可能相对常见。身体变形障碍的共病可能表明病情更为严重。
