Thirty-three cases of body dysmorphic disorder in children and adolescents
Thirty-three cases of body dysmorphic disorder in children and adolescents
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DOI：
10.1097/00004583-199904000-00019
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发表时间：
1999-04-01
影响因子：
13.3
通讯作者：
Phillips, KA
中科院分区：
文献类型：
--
作者：
Albertini, RS;Phillips, KA
目的：躯体变形障碍(BDD)是一种以外观不存在或轻微缺陷为主要症状的疾病，通常始于青春期。由于还没有关于儿童和青少年BDD的临床特征的研究，作者对这些特征进行了迄今为止最大规模的系列评估。方法：对33例患有DSM-IV BDD的儿童和青少年的人口学特征、现象学、相关的精神病理学、治疗史和反应进行评估。结果：身体上的注意力最多集中在皮肤(61%)和头发(55%)上。所有受试者都有相关的强迫行为，94%的人最常伪装(例如，用衣服)，相比之下，其他人(87%)和照镜子(85%)。94%的人报告说，由于BDD，他们的社交功能受损，85%的人在学习或工作功能方面存在障碍。39%的人曾在精神科住院，21%的人曾试图自杀。在接受5-羟色胺再摄取抑制剂治疗的19名受试者中，有10名(53%)的BDD症状有很大或非常大的改善；相比之下，使用其他精神药物的8次试验中有0次，认知行为治疗试验中的1次试验中有0次有改善，20次心理治疗试验中有1次有改善。12名受试者(36%)接受了外科、皮肤科或牙科治疗，所有病例的结果都很差。结论：BDD可在儿童和青少年中引起显著的发病率。这些初步数据表明，5-羟色胺再摄取抑制剂可能是这一年龄段的有效治疗方法。
Objective: Body dysmorphic disorder (BDD), a preoccupation with a nonexistent or slight defect in appearance, usually begins during adolescence. Because there have been no studies of the clinical features of BDD in children and adolescents, the authors assessed these features in the largest series to date. Method: Thirty-three children and adolescents with DSM-IV BDD were assessed for demographic characteristics, phenomenology, associated psychopathology, and treatment history and response. Results: Bodily preoccupations most often focused on the skin (61%) and hair (55%). All subjects had associated compulsive behaviors, most often camouflaging (e.g., with clothing) in 94%, comparing with others (87%), and mirror checking (85%). Ninety-four percent reported impairment in social functioning and 85% in academic or job functioning due to BDD. Thirty-nine percent had had psychiatric hospitalizations, and 21% had made a suicide attempt. Ten (53%) of 19 subjects treated with a serotonin reuptake inhibitor had much or very much improvement in BDD symptoms; in contrast, 0 of 8 trials with other psychotropic medications, 0 of 1 trial of cognitive-behavioral therapy, and 1 of 20 psychotherapy trials resulted in improvement. Twelve (36%) subjects received surgical, dermatological, or dental treatment, with a poor outcome in all cases. Conclusions: BDD can cause significant morbidity in children and adolescents. These preliminary data suggest that serotonin reuptake inhibitors may be an effective treatment in this age group.