Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden and Stockholm Health Care Services, Region Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden and Stockholm Health Care Services, Region Stockholm, Sweden.
Biol Psychiatry. 2024 Dec 1;96(11):868-875. doi: 10.1016/j.biopsych.2024.05.006. Epub 2024 May 9.
Body dysmorphic disorder (BDD) is thought to be associated with considerable suicide risk. This nationwide cohort study quantified the risks of intentional self-harm-including nonsuicidal self-injuries and suicide attempts-and death by suicide in BDD.
Individuals with a validated ICD-10 diagnosis of BDD in the Swedish National Patient Register, registered between January 1, 1997, and December 31, 2020, were matched with 10 unexposed individuals (i.e., without BDD) from the general population on birth year, sex, and county of residence. Conditional Poisson regression models estimated incidence rate ratios and 95% CIs for intentional self-harm. Stratified Cox proportional hazards models estimated hazard ratios and 95% CIs for death by suicide. Models adjusted for sociodemographic variables and lifetime psychiatric comorbidities.
Among 2833 individuals with BDD and 28,330 unexposed matched individuals, 466 (16.45%) and 1071 (3.78%), respectively, had at least 1 record of intentional self-harm during the study period (incidence rate ratio = 3.37; 95% CI, 3.02-3.76). In the BDD group, about two-thirds (n = 314; 67%) had their first recorded self-harm event before their first BDD diagnosis. A total of 17 (0.60%) individuals with BDD and 27 (0.10%) unexposed individuals died by suicide (hazard ratio = 3.47; 95% CI, 1.76-6.85). All results remained robust to additional adjustment for lifetime psychiatric comorbidities. A higher proportion of individuals with BDD who died by suicide had at least 1 previous record of intentional self-harm compared with unexposed individuals (52.94% vs. 22.22%; p = .036).
BDD was associated with a 3-fold increased risk of intentional self-harm and death by suicide.
躯体变形障碍（BDD）被认为与相当大的自杀风险有关。这项全国性队列研究量化了 BDD 患者中故意自残（包括非自杀性自伤和自杀企图）和自杀死亡的风险。
在瑞典国家患者登记处，从 1997 年 1 月 1 日至 2020 年 12 月 31 日，对经 ICD-10 确诊的 BDD 患者进行了匹配，与一般人群中的 10 名未暴露个体（即无 BDD）按出生年份、性别和居住地进行匹配。条件泊松回归模型估计了故意自残的发病率比和 95%置信区间。分层 Cox 比例风险模型估计了自杀死亡的风险比和 95%置信区间。模型调整了社会人口统计学变量和终生精神共病。
在 2833 名 BDD 患者和 28330 名未暴露匹配个体中，分别有 466 名（16.45%）和 1071 名（3.78%）在研究期间至少有 1 次故意自残记录（发病率比=3.37；95%置信区间，3.02-3.76）。在 BDD 组中，约 2/3（n=314；67%）在首次 BDD 诊断前首次记录到自残事件。共有 17 名（0.60%）BDD 患者和 27 名（0.10%）未暴露个体自杀（风险比=3.47；95%置信区间，1.76-6.85）。所有结果在进一步调整终生精神共病后仍然稳健。与未暴露个体相比，自杀的 BDD 患者中至少有 1 次故意自残记录的比例更高（52.94% vs. 22.22%；p=0.036）。
BDD 与故意自残和自杀死亡的风险增加 3 倍有关。
