Phillips Katharine A
Dr. Phillips is professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University and director of the Body Dysmorphic Disorder and Body Image Program at Butler Hospital in Providence, Rhode Island.
Prim psychiatry. 2007 Dec;14(12):58-66.
Suicidal ideation, suicide attempts, and completed suicide appear common in individuals with body dysmorphic disorder (BDD). Available evidence indicates that approximately 80% of individuals with BDD experience lifetime suicidal ideation and 24% to 28% have attempted suicide. Although data on completed suicide are limited and preliminary, the suicide rate appears markedly high. These findings underscore the importance of recognizing and effectively treating BDD. However, BDD is underrecognized in clinical settings even though it is relatively common and often presents to psychiatrists and other mental health practitioners, dermatologists, surgeons, and other physicians. This article reviews available evidence on suicidality in BDD and discusses how to recognize and diagnose this often secret disorder. Efficacious treatments for BDD, ie, serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy, are also discussed. Although data are limited, it appears that SRIs often diminish suicidality in these patients. Additional research is greatly needed on suicidality rates, characteristics, correlates, risk factors, treatment, and prevention of suicidality in BDD.
自杀观念、自杀未遂和自杀死亡在躯体变形障碍（BDD）患者中似乎很常见。现有证据表明，约80%的BDD患者有过终生自杀观念，24%至28%的患者曾试图自杀。虽然关于自杀死亡的数据有限且尚属初步，但自杀率似乎明显偏高。这些发现凸显了识别并有效治疗BDD的重要性。然而，BDD在临床环境中未得到充分认识，尽管它相对常见，且经常出现在精神科医生和其他心理健康从业者、皮肤科医生、外科医生及其他医生面前。本文回顾了关于BDD患者自杀行为的现有证据，并讨论了如何识别和诊断这种常隐匿的疾病。文中还讨论了BDD的有效治疗方法，即5-羟色胺再摄取抑制剂（SRIs）和认知行为疗法。虽然数据有限，但SRIs似乎常常能减轻这些患者的自杀倾向。对于BDD患者的自杀率、特征、相关因素、危险因素、治疗及自杀预防，非常需要开展更多研究。
