Body Dysmorphic Disorder and Self-esteem in Adolescents and Young Adults with Acne Vulgaris
DOI:
https://doi.org/10.2340/actadv.v103.6232Keywords:
acne, body dysmorphic disorder, self-esteemAbstract
Body dysmorphic disorder is a mental health disorder characterized by a preoccupation with a perceived flaw, which is commonly seen among dermatology patients. The objective of this study was to determine the frequency of body dysmorphic disorder and assess self-esteem among a clinical sample of adolescents and young adults being managed for acne vulgaris. A total of 105 patients, age range 13–24 years, receiving acne treatment at 1 of 2 dermatology outpatient clinic were included. A self-report questionnaire was used, which included a body dysmorphic disorder screening tool (based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria) and the Rosenberg Self-Esteem Scale (RSES). Acne was graded with the Cook’s acne grading scale. Out of 105 adolescents and young adults visiting a dermatologist due to acne, 13 (12.4%) screened positive for body dysmorphic disorder (95% confidence interval (95% CI) 6.8–20.2%). Patients with body dysmorphic disorder were more likely to have female gender (p = 0.020) and had lower self-esteem (RSES 15.8 vs 20.5, respectively, p = 0.013) compared with patients without body dysmorphic disorder. No differences were found in the frequency of body dysmorphic disorder with DSM-IV or DSM-5 criteria. This is the first study to report on the frequency of body dysmorphic disorder and self-esteem in adolescents and young adults with acne. Ultimately, more awareness of body dysmorphic disorder among adolescents and young adults presenting with dermatological disorders could lead to more rapid recognition and referral to psychiatric units.
Downloads
References
Veale D. Body dysmorphic disorder. Postgrad Med J 2004; 80: 67-71.
https://doi.org/10.1136/pmj.2003.015289 DOI: https://doi.org/10.1136/pmj.2003.015289
Battle DE. Diagnostic and Statistical Manual of Mental Disorders (DSM). Codas 2013; 25: 191-192.
Phillips KA. Body dysmorphic disorder: clinical features, Uptodate, 2022. [Accessed June 1, 2022] Available from: https://www.uptodate.com/contents/body-dysmorphic-disorder-clinical-features.
Schneider SC, Turner CM, Storch EA, Hudson JL. Body dysmorphic disorder symptoms and quality of life: the role of clinical and demographic variables. J Obsessive Compuls Relat Disord 2019; 21: 1-5.
https://doi.org/10.1016/j.jocrd.2018.11.002 DOI: https://doi.org/10.1016/j.jocrd.2018.11.002
Phillips KA. Suicidality in body dysmorphic disorder. Prim psychiatry 2007; 14: 58-66.
https://doi.org/10.1037/e721432007-007 DOI: https://doi.org/10.1037/e721432007-007
Hong K, Nezgovorova V, Uzunova G, Schlussel D, and Hollander E. Pharmacological treatment of body dysmorphic disorder. Curr Neuropharmacol 2019; 17: 697-702.
https://doi.org/10.2174/1570159X16666180426153940 DOI: https://doi.org/10.2174/1570159X16666180426153940
Rautio D, Gumpert M, Jassi A, Krebs G, Flygare O, Andren P, et al. Effectiveness of multimodal treatment for young people with body dysmorphic disorder in two specialist clinics. Behav Ther 2022; 53: 1037-1049.
https://doi.org/10.1016/j.beth.2022.04.010 DOI: https://doi.org/10.1016/j.beth.2022.04.010
Phillips KA, Didie ER, Menard W. Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder,. J Affect Disord 2007; 97: 129-135.
https://doi.org/10.1016/j.jad.2006.06.006 DOI: https://doi.org/10.1016/j.jad.2006.06.006
Dennin MH, Lee MS. Body dysmorphic disorder in pediatric dermatology. Pediatr Dermatol 2018; 35: 868-874.
https://doi.org/10.1111/pde.13581 DOI: https://doi.org/10.1111/pde.13581
Bjornsson AS, Didie ER, Phillips KA. Body dysmorphic disorder. Dialogues Clin Neurosci 2010; 12: 221-232.
https://doi.org/10.31887/DCNS.2010.12.2/abjornsson DOI: https://doi.org/10.31887/DCNS.2010.12.2/abjornsson
Angelakis I, Gooding PA, Panagioti M. Suicidality in body dysmorphic disorder (BDD): a systematic review with meta-analysis. Clin Psychol Rev 2016; 49: 55-66.
https://doi.org/10.1016/j.cpr.2016.08.002 DOI: https://doi.org/10.1016/j.cpr.2016.08.002
Ribeiro RVE. Frequency of body dysmorphic disorder in plastic surgery and dermatology patients: a systematic review with meta-analysis. Aesthetic Plast Surg 2017; 41: 964-970.
https://doi.org/10.1007/s00266-017-0869-0 DOI: https://doi.org/10.1007/s00266-017-0869-0
Castle DJ, Phillips KA, Dufresne RG. Body dysmorphic disorder and cosmetic dermatology: more than skin deep. J Cosmet Dermatol 2004; 3: 99-103.
https://doi.org/10.1111/j.1473-2130.2004.00105.x DOI: https://doi.org/10.1111/j.1473-2130.2004.00105.x
Marron SE, Gracia-Cazaña T, Miranda-Sivelo A, Lamas-Diaz S, Tomas-Aragones L. Screening for body dysmorphic disorders in acne patients: a pilot study. Actas Dermosifiliogr 2019; 110: 28-32. DOI: https://doi.org/10.1016/j.adengl.2018.11.001
https://doi.org/10.1016/j.ad.2018.08.001 DOI: https://doi.org/10.1016/j.ad.2018.08.001
Cotterill JA. Body dysmorphic disorder. Dermatol Clin 1996; 14: 457-463.
https://doi.org/10.1016/S0733-8635(05)70373-9 DOI: https://doi.org/10.1016/S0733-8635(05)70373-9
Higgins S, Wysong A. Cosmetic surgery and body dysmorphic disorder - an update. Int J Womens Dermatol 2018; 4: 43-48.
https://doi.org/10.1016/j.ijwd.2017.09.007 DOI: https://doi.org/10.1016/j.ijwd.2017.09.007
McClure AC, Tanski SE, Kingsbury J, Gerrard M, Sargent SD. Characteristics associated with low self-esteem among US adolescents. Acad Pediatr 2010; 10: 238-244.
https://doi.org/10.1016/j.acap.2010.03.007 DOI: https://doi.org/10.1016/j.acap.2010.03.007
Wang F, Veugelers PJ. Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obes Rev 2008; 9: 615-623.
https://doi.org/10.1111/j.1467-789X.2008.00507.x DOI: https://doi.org/10.1111/j.1467-789X.2008.00507.x
Gallitano SM, Berson DS. How acne bumps cause the blues: the influence of acne vulgaris on self-esteem. Int J Womens Dermatol 2018; 4: 12-17.
https://doi.org/10.1016/j.ijwd.2017.10.004 DOI: https://doi.org/10.1016/j.ijwd.2017.10.004
Kuck N, Cafitz L, Burkner PC, Hoppen L, Wilhelm S, Buhlmann U. Body dysmorphic disorder and self-esteem: a meta-analysis. BMC Psychiatry 2021; 21: 310.
https://doi.org/10.1186/s12888-021-03185-3 DOI: https://doi.org/10.1186/s12888-021-03185-3
Cerea S, Bottesi G, Grisham JR, Ghisi M. Body dysmorphic disorder and its associated psychological and psychopathological features in an Italian community sample. Int J Psychiatry Clin Pract 2018; 22: 206-214.
https://doi.org/10.1080/13651501.2017.1393545 DOI: https://doi.org/10.1080/13651501.2017.1393545
Marques LC, Bürkner L. The relationship between perceived social support and severity of body dysmorphic disorder symptoms: the role of gender. Rev Bras Psiquiatr 2011; 33: 238-244. DOI: https://doi.org/10.1590/S1516-44462011005000010
https://doi.org/10.1590/S1516-44462011000300006 DOI: https://doi.org/10.1590/S1516-44462011000300006
Hartmann AS, Lyons N. Body dysmorphic disorder. Wiley Handb Obs Compuls Disord 2017; 8: 774-789.
https://doi.org/10.1002/9781118890233.ch43 DOI: https://doi.org/10.1002/9781118890233.ch43
Rood van Y, Wijk N. Validation of the Body Dysmorphic Screener of DSM-5 criteria (BDDS-5) 2019. Available from: https://studenttheses.uu.nl/bitstream/handle/20.500.12932/35704/Wyk,%20van%20(4121309)%20thesis.pdf?sequence=1.
Rosenberg M. Rosenberg Self-Esteem Scale (RSES). APA PsycTests 1965.
https://doi.org/10.1037/t01038-000 DOI: https://doi.org/10.1037/t01038-000
Cook CH, Centner RL, Michaels SE. An acne grading method using photographic standards. Arch Dermatol 1979; 115: 571-575. DOI: https://doi.org/10.1001/archderm.115.5.571
https://doi.org/10.1001/archderm.1979.04010050005003 DOI: https://doi.org/10.1001/archderm.1979.04010050005003
Veale D, Gledhill LJ, Christodoulou P, Hodsoll J. Body dysmorphic disorder in different settings: a systematic review and estimated weighted frequency. Body Image 2016; 18: 168-186.
https://doi.org/10.1016/j.bodyim.2016.07.003 DOI: https://doi.org/10.1016/j.bodyim.2016.07.003
Schieber K, Kollei I, de Zwaan M, Martin A. Classification of body dysmorphic disorder - what is the advantage of the new DSM-5 criteria? J Psychosom Res 2015; 78: 223-227.
https://doi.org/10.1016/j.jpsychores.2015.01.002 DOI: https://doi.org/10.1016/j.jpsychores.2015.01.002
Marron SE et al. Body dysmorphic disorder in patients with acne: a multicentre study. J Eur Acad Dermatol Venereol 2020; 34: 370-376.
https://doi.org/10.1111/jdv.15954 DOI: https://doi.org/10.1111/jdv.15954
Hassan J, Grogan S, Clark-Carter D, Richards H, Yates VM. The individual health burden of acne: appearance-related distress in male and female adolescents and adults with back, chest and facial acne. J Health Psychol 2009; 14: 1105-1118.
https://doi.org/10.1177/1359105309342470 DOI: https://doi.org/10.1177/1359105309342470
Franzke N, Zimmer L, Schafer I, Radermacher C, Kresken J, Augustin M. Quality of medical care of patients with acne vulgaris in Germany-nationwide survey of pharmacy clients. J Dtsch Dermatol Ges 2009; 7: 1060-1063.
https://doi.org/10.1111/j.1610-0387.2009.07155.x DOI: https://doi.org/10.1111/j.1610-0387.2009.07155.x
Mollmann A, Dietel F, Hunger A, Buhlmann U, Frequency of body dysmorphic disorder and associated features in German adolescents: a self-report survey. Psychiatry Res 2017; 254: 263-267.
https://doi.org/10.1016/j.psychres.2017.04.063 DOI: https://doi.org/10.1016/j.psychres.2017.04.063
Additional Files
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Benjamin G. Tros, Patrick M.J.H. Kemperman, Jade Kuckulus, Rick Hoekzema, Nienke C.C. Vulink
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
