Clinical characteristics of 172 children and adolescents with body dysmorphic disorder

Daniel Rautio, Amita Jassi, Georgina Krebs, Per Andren, Benedetta Monzani, Martina Gumpert, Angela Lewis, Lauren Peile, Laura Sevilla-Cermeño, Markus Jansson-Fröjmark, Tobias Lundgren, Maria Hillborg, Maria Silverberg-Morse, Bruce Clark, Lorena Fernández de la Cruz, David Mataix-Cols

Research output: Contribution to journalArticlepeer-review


Body dysmorphic disorder (BDD) often starts in childhood, with most cases developing symptoms before age 18. Yet, BDD research has primarily focused on adults. We report the clinical characteristics of the world’s largest cohort of carefully diagnosed youths with BDD and focus on previously unexplored sex and age differences. We systematically collected clinical data from 172 young people with BDD consecutively referred to two specialist pediatric obsessive-compulsive and related disorders outpatient clinics in Stockholm, Sweden and in London, England. A series of clinician-, self-, and parent-reported measures were administered. The cohort consisted of 136 girls, 32 boys, and four transgender individuals (age range 10-19 years). The mean severity of BDD symptoms was in the moderate to severe range, with more than one third presenting with severe symptoms and more than half showing poor or absent insight/delusional beliefs. We observed high rates of current psychiatric comorbidity (71.5%), past or current self-harm (52.1%), suicide attempts (11.0%), current desire for cosmetic procedures (53.7%), and complete school dropout (32.4%). Compared to boys, girls had significantly more severe self-reported BDD symptoms, depression, suicidal thoughts, and self-harm. Compared to the younger participants (14 or younger), older participants had significantly more severe compulsions and were more likely to report a desire for conducting cosmetic procedures. Adolescent BDD can be a severe and disabling disorder associated with significant risks and substantial functional impairment. The clinical presentation of the disorder is largely similar across sexes and age groups, indicating the importance of early detection and treatment. More research is needed specifically focusing on boys and pre-pubertal individuals with BDD.
Original languageEnglish
JournalEuropean Child and Adolescent Psychiatry
Publication statusAccepted/In press - 25 Oct 2020


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