1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia.
2 Department of Psychiatry, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2018 Nov;52(11):1030-1049. doi: 10.1177/0004867418799925. Epub 2018 Sep 21.
Current nosology conceptualises body dysmorphic disorder as being related to obsessive-compulsive disorder, but the direct evidence to support this conceptualisation is mixed. In this systematic review, we aimed to provide an integrated overview of research that has directly compared body dysmorphic disorder and obsessive-compulsive disorder.
The PubMed database was searched for empirical studies which had directly compared body dysmorphic disorder and obsessive-compulsive disorder groups across any subject matter. Of 379 records, 31 met inclusion criteria and were reviewed.
Evidence of similarities between body dysmorphic disorder and obsessive-compulsive disorder was identified for broad illness features, including age of onset, illness course, symptom severity and level of functional impairment, as well as high perfectionism and high fear of negative evaluation. However, insight was clearly worse in body dysmorphic disorder than obsessive-compulsive disorder, and preliminary data also suggested unique visual processing features, impaired facial affect recognition, increased social anxiety severity and overall greater social-affective dysregulation in body dysmorphic disorder relative to obsessive-compulsive disorder.
Limitations included a restricted number of studies overall, an absence of studies comparing biological parameters (e.g. neuroimaging), and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. Risks of interpreting common features as indications of shared underlying mechanisms are explored, and evidence of differences between the disorders are placed in the context of broader research findings. Overall, this review suggests that the current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.
目前的分类学将躯体变形障碍概念化为与强迫症有关，但支持这种概念化的直接证据存在分歧。在本系统评价中，我们旨在提供直接比较躯体变形障碍和强迫症的研究的综合概述。
在 PubMed 数据库中搜索了直接比较躯体变形障碍和强迫症组的实证研究，研究主题不限。在 379 条记录中，有 31 条符合纳入标准并进行了综述。
在广泛的疾病特征方面，包括发病年龄、疾病过程、症状严重程度和功能障碍程度，以及高度完美主义和高度害怕负面评价，发现了躯体变形障碍和强迫症之间的相似性证据。然而，躯体变形障碍的洞察力明显比强迫症差，初步数据还表明躯体变形障碍存在独特的视觉处理特征、面部情感识别受损、社交焦虑严重程度增加以及整体社会情感调节功能障碍更大。
总体而言，本研究存在一些局限性，包括研究数量有限、缺乏比较生物学参数（如神经影像学）的研究，以及经常纳入伴有躯体变形障碍和强迫症共病的参与者。解释共同特征是否表明存在共同潜在机制的风险得到了探讨，并将这些障碍之间的差异置于更广泛的研究结果的背景下。总体而言，本综述表明躯体变形障碍的当前分类地位有些脆弱，需要进一步研究，特别关注维度、生物学和病因学因素。
