Sampogna F, Samela T, Abeni D, Schut C, Kupfer J, Bewley A P, Finlay A Y, Gieler U, Thompson A R, Gracia-Cazaña T, Balieva F, Ferreira B R, Jemec G B, Lien L, Misery L, Marron S E, Ständer S, Zeidler C, Szabó C, Szepietowski J C, Reich A, Svensson A, Altunay I K, Legat F J, Grivcheva-Panovska V, Romanov D V, Lvov A N, Titeca G, Vulink N C, Tomás-Aragones L, van Beugen S, Evers A W M, Dalgard F J
Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy.
Institute of Medical Psychology, Justus-Liebig-University Gießen, Gießen, Germany.
J Eur Acad Dermatol Venereol. 2025 Apr;39(4):823-832. doi: 10.1111/jdv.20247. Epub 2024 Jul 25.
Dysmorphic concern is an overconcern with an imagined or slight defect in physical appearance that can be a symptom of body dysmorphic disorder (BDD). Appearance-related concerns are frequently reported by people with dermatological conditions. However, relatively little remains known about the relationship between dysmorphic concern and other variables within persons with different skin conditions.
The aim of this multicentre, cross-sectional study was to investigate gender differences regarding dysmorphic concern and the prevalence of BDD in a large sample of patients with skin conditions, in relation to sociodemographic, clinical and psychological variables.
Participants aged ≥18 years with skin conditions were consecutively enrolled in dermatological clinics of 22 European centres. Dysmorphic concern and the possible presence of BDD were measured using the Dysmorphic Concern Questionnaire (DCQ) and compared between men and women in relation to sociodemographic, clinical and psychological variables, and separately for each skin condition.
The DCQ questionnaire was completed by 5290 dermatological patients. In all categories, mean scores were significantly higher in women than in men. Mean DCQ scores were also higher in women for most skin conditions, with the highest effect size in vitiligo. The percentage of patients who screened positive for BDD on the DCQ was 10.5%, 7.7% of men and 12.7% of women. The prevalence of BDD positive was 6.9% in patients with mild clinical severity, 11.1% for moderate and 19.1% for severe condition. In the multivariate model in patients with mild skin condition, the presence of BDD was positively associated with stress and stigma both in men and in women.
Dysmorphic concern and BDD were more frequent in women than in men with skin conditions. Both received and actual stigmatization might have an impact on body-related concerns, in particular in women, who may be more at risk for sociocultural reasons.
畸形担忧是对想象中的或轻微的外表缺陷过度关注，这可能是躯体变形障碍（BDD）的一种症状。皮肤病患者经常报告与外表相关的担忧。然而，关于不同皮肤状况患者中畸形担忧与其他变量之间的关系，人们了解得相对较少。
这项多中心横断面研究的目的是调查在一大群皮肤病患者中，与社会人口统计学、临床和心理变量相关的畸形担忧方面的性别差异以及BDD的患病率。
年龄≥18岁的皮肤病患者在22个欧洲中心的皮肤科诊所连续入组。使用畸形担忧问卷（DCQ）测量畸形担忧和BDD的可能存在情况，并在男性和女性之间就社会人口统计学、临床和心理变量进行比较，且针对每种皮肤状况分别进行比较。
5290名皮肤科患者完成了DCQ问卷。在所有类别中，女性的平均得分显著高于男性。在大多数皮肤状况中，女性的DCQ平均得分也更高，白癜风的效应量最高。DCQ筛查BDD呈阳性的患者比例为10.5%，男性为7.7%，女性为12.7%。临床严重程度为轻度的患者中BDD阳性患病率为6.9%，中度为11.1%，重度为19.1%。在轻度皮肤状况患者的多变量模型中，BDD的存在在男性和女性中均与压力和耻辱感呈正相关。
皮肤病女性中畸形担忧和BDD比男性更常见。所遭受的和实际的耻辱感可能会对与身体相关的担忧产生影响，尤其是对女性，由于社会文化原因，她们可能面临更大风险。
