Didie Elizabeth R, Menard William, Stern Adam P, Phillips Katharine A
Butler Hospital, Providence, RI 02906, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02912, USA.
Compr Psychiatry. 2008 Nov-Dec;49(6):561-9. doi: 10.1016/j.comppsych.2008.04.003. Epub 2008 Jul 2.
Body dysmorphic disorder (BDD) is relatively common and appears to be associated with marked impairment in psychosocial functioning. Previous reports, however, did not investigate occupational functioning in detail, assess impairment specifically in occupational functioning using standardized measures in a nontreatment seeking sample, or examine correlates of occupational impairment.
Occupational functioning and other clinical variables were assessed in 141 adults with BDD. Measures included the Range of Impaired Functioning Tool and other reliable and valid self-report and interviewer-administered measures.
Fewer than half of subjects were working full-time, and 22.7% were receiving disability pay. Thirty-nine percent of the sample reported not working in the past month because of psychopathology. Of those subjects who worked in the past month, 79.7% reported impairment in work functioning because of psychopathology. Adults with BDD who were not working because of psychopathology were comparable to subjects who were working in most demographic variables, delusionality of BDD beliefs, and duration of BDD. However, compared to subjects who worked in the past month, those not currently working because of psychopathology had more severe BDD and more chronic BDD. They also were more likely to be male, had less education, and had more severe depressive symptoms, a higher rate of certain comorbid disorders, poorer current social functioning and quality of life, a higher rate of lifetime suicidality, and were more likely to have been psychiatrically hospitalized.
A high proportion of individuals with BDD were unable to work because of psychopathology; most who worked reported impairment in occupational functioning. Certain clinical variables, including more severe and chronic BDD, were associated with not working.
躯体变形障碍（BDD）相对常见，似乎与心理社会功能的显著损害有关。然而，既往报告并未详细调查职业功能，未使用标准化测量方法在未寻求治疗的样本中专门评估职业功能损害，也未研究职业损害的相关因素。
对141名患有BDD的成年人的职业功能和其他临床变量进行评估。测量方法包括功能受损范围工具以及其他可靠且有效的自我报告和访谈者管理的测量方法。
不到一半的受试者全职工作，22.7%的人领取残疾抚恤金。39%的样本报告称，由于精神病理学原因，在过去一个月没有工作。在过去一个月工作的受试者中，79.7%报告称由于精神病理学原因工作功能受损。因精神病理学原因未工作的BDD成年人在大多数人口统计学变量、BDD信念的妄想性以及BDD病程方面与工作的受试者相当。然而，与过去一个月工作的受试者相比，目前因精神病理学原因未工作的受试者BDD更严重、病程更长。他们也更可能是男性，受教育程度较低，抑郁症状更严重，某些共病的发生率更高，当前社会功能和生活质量较差，终身自杀率更高，并且更可能曾接受过精神科住院治疗。
很大一部分BDD患者因精神病理学原因无法工作；大多数工作的患者报告存在职业功能损害。某些临床变量，包括更严重和慢性的BDD，与不工作有关。
