Behar Rosa, Arancibia Marcelo, Heitzer Cristóbal, Meza Nicolás
Rev Med Chil. 2016 May;144(5):626-33. doi: 10.4067/S0034-98872016000500011.
There is strong evidence about the co-existence of body dysmorphic disorder (BDD) and eating disorders (ED), particularly with anorexia nervosa (AN). An exhaustive review of the specialised literature regarding these disorders was carried out. The results show that their co-occurrence implies a more complex diagnosis and treatment, a more severe clinical symptomatology and a worse prognosis and outcome. Both disorders display common similarities, differences and comorbidities, which allow authors to classify them in different nosological spectra (somatomorphic, anxious, obsessive-compulsive, affective and psychotic). Their crossover involves higher levels of body dissatisfaction and body image distortion, depression, suicidal tendency, personality disorders, substance use/abuse, obsessive-compulsive disorder, social phobia, alexithymia and childhood abuse or neglect background. Treatment including cognitive-behavioral psychotherapy and selective reuptake serotonin inhibitors are effective for both, BDD and ED; nevertheless, plastic surgery could exacerbate BDD. Clinical traits of BDD must be systematically detected in patients suffering from ED and vice versa.
有充分证据表明身体变形障碍（BDD）与饮食失调（ED），尤其是神经性厌食症（AN）并存。我们对有关这些疾病的专业文献进行了详尽回顾。结果表明，它们的共病意味着诊断和治疗更为复杂，临床症状更为严重，预后和结局更差。这两种疾病表现出共同的相似之处、差异和共病情况，这使得作者能够将它们归类于不同的疾病分类谱（躯体变形、焦虑、强迫、情感和精神病性）。它们的交叉涉及更高程度的身体不满和身体形象扭曲、抑郁、自杀倾向、人格障碍、物质使用/滥用、强迫症、社交恐惧症、述情障碍以及童年期虐待或忽视背景。包括认知行为心理治疗和选择性5-羟色胺再摄取抑制剂在内的治疗方法对BDD和ED均有效；然而，整形手术可能会加重BDD。对于患有ED的患者必须系统地检测BDD的临床特征，反之亦然。
