Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study

Jesper Enander; Volen Z. Ivanov; David Mataix-Cols; Ralf Kuja-Halkola; Brjánn Ljótsson; Sebastian Lundström; Ana Pérez-Vigil; Benedetta Monzani; Paul Lichtenstein; Christian Rück

doi:10.1017/S0033291718000375

Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study

Jesper Enander^*, Volen Z. Ivanov, David Mataix-Cols, Ralf Kuja-Halkola, Brjánn Ljótsson, Sebastian Lundström, Ana Pérez-Vigil, Benedetta Monzani, Paul Lichtenstein, Christian Rück

^*Corresponding author for this work

Psychosis Studies

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Abstract

Background: Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated the prevalence of BDD symptoms in adolescents and young adults. We also report on the relative importance of genetic and environmental influences on BDD symptoms, and the risk for co-existing psychopathology. Methods: Prevalence of BDD symptoms was determined by a validated cut-off on the Dysmorphic Concerns Questionnaire (DCQ) in three population-based twin cohorts at ages 15 (n = 6968), 18 (n = 3738), and 20–28 (n = 4671). Heritability analysis was performed using univariate model-fitting for the DCQ. The risk for co-existing psychopathology was expressed as odds ratios (OR). Results: The prevalence of clinically significant BDD symptoms was estimated to be between 1 and 2% in the different cohorts, with a significantly higher prevalence in females (1.3–3.3%) than in males (0.2–0.6%). The heritability of body dysmorphic concerns was estimated to be 49% (95% CI 38–54%) at age 15, 39% (95% CI 30–46) at age 18, and 37% (95% CI 29–42) at ages 20–28, with the remaining variance being due to non-shared environment. ORs for co-existing neuropsychiatric and alcohol-related problems ranged from 2.3 to 13.2. Conclusions: Clinically significant BDD symptoms are relatively common in adolescence and young adulthood, particularly in females. The low occurrence of BDD symptoms in adolescent boys may indicate sex differences in age of onset and/or etiological mechanisms. BDD symptoms are moderately heritable in young people and associated with an increased risk for co-existing neuropsychiatric and alcohol-related problems.

Original language	English
Pages (from-to)	1-8
Number of pages	8
Journal	Psychological Medicine
Early online date	28 Feb 2018
DOIs	https://doi.org/10.1017/S0033291718000375
Publication status	E-pub ahead of print - 28 Feb 2018

Keywords

Body dysmorphic disorder
comorbidity
heritability
obsessive-compulsive disorder
prevalence
twin study

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Enander, J., Ivanov, V. Z., Mataix-Cols, D., Kuja-Halkola, R., Ljótsson, B., Lundström, S., Pérez-Vigil, A., Monzani, B., Lichtenstein, P., & Rück, C. (2018). Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study. Psychological Medicine, 1-8. Advance online publication. https://doi.org/10.1017/S0033291718000375

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title = "Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study",

abstract = "Background: Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated the prevalence of BDD symptoms in adolescents and young adults. We also report on the relative importance of genetic and environmental influences on BDD symptoms, and the risk for co-existing psychopathology. Methods: Prevalence of BDD symptoms was determined by a validated cut-off on the Dysmorphic Concerns Questionnaire (DCQ) in three population-based twin cohorts at ages 15 (n = 6968), 18 (n = 3738), and 20–28 (n = 4671). Heritability analysis was performed using univariate model-fitting for the DCQ. The risk for co-existing psychopathology was expressed as odds ratios (OR). Results: The prevalence of clinically significant BDD symptoms was estimated to be between 1 and 2% in the different cohorts, with a significantly higher prevalence in females (1.3–3.3%) than in males (0.2–0.6%). The heritability of body dysmorphic concerns was estimated to be 49% (95% CI 38–54%) at age 15, 39% (95% CI 30–46) at age 18, and 37% (95% CI 29–42) at ages 20–28, with the remaining variance being due to non-shared environment. ORs for co-existing neuropsychiatric and alcohol-related problems ranged from 2.3 to 13.2. Conclusions: Clinically significant BDD symptoms are relatively common in adolescence and young adulthood, particularly in females. The low occurrence of BDD symptoms in adolescent boys may indicate sex differences in age of onset and/or etiological mechanisms. BDD symptoms are moderately heritable in young people and associated with an increased risk for co-existing neuropsychiatric and alcohol-related problems.",

keywords = "Body dysmorphic disorder, comorbidity, heritability, obsessive-compulsive disorder, prevalence, twin study",

author = "Jesper Enander and Ivanov, {Volen Z.} and David Mataix-Cols and Ralf Kuja-Halkola and Brj{\'a}nn Lj{\'o}tsson and Sebastian Lundstr{\"o}m and Ana P{\'e}rez-Vigil and Benedetta Monzani and Paul Lichtenstein and Christian R{\"u}ck",

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T1 - Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults

T2 - a population-based nationwide twin study

AU - Enander, Jesper

AU - Ivanov, Volen Z.

AU - Mataix-Cols, David

AU - Kuja-Halkola, Ralf

AU - Ljótsson, Brjánn

AU - Lundström, Sebastian

AU - Pérez-Vigil, Ana

AU - Monzani, Benedetta

AU - Lichtenstein, Paul

AU - Rück, Christian

PY - 2018/2/28

Y1 - 2018/2/28

N2 - Background: Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated the prevalence of BDD symptoms in adolescents and young adults. We also report on the relative importance of genetic and environmental influences on BDD symptoms, and the risk for co-existing psychopathology. Methods: Prevalence of BDD symptoms was determined by a validated cut-off on the Dysmorphic Concerns Questionnaire (DCQ) in three population-based twin cohorts at ages 15 (n = 6968), 18 (n = 3738), and 20–28 (n = 4671). Heritability analysis was performed using univariate model-fitting for the DCQ. The risk for co-existing psychopathology was expressed as odds ratios (OR). Results: The prevalence of clinically significant BDD symptoms was estimated to be between 1 and 2% in the different cohorts, with a significantly higher prevalence in females (1.3–3.3%) than in males (0.2–0.6%). The heritability of body dysmorphic concerns was estimated to be 49% (95% CI 38–54%) at age 15, 39% (95% CI 30–46) at age 18, and 37% (95% CI 29–42) at ages 20–28, with the remaining variance being due to non-shared environment. ORs for co-existing neuropsychiatric and alcohol-related problems ranged from 2.3 to 13.2. Conclusions: Clinically significant BDD symptoms are relatively common in adolescence and young adulthood, particularly in females. The low occurrence of BDD symptoms in adolescent boys may indicate sex differences in age of onset and/or etiological mechanisms. BDD symptoms are moderately heritable in young people and associated with an increased risk for co-existing neuropsychiatric and alcohol-related problems.

AB - Background: Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated the prevalence of BDD symptoms in adolescents and young adults. We also report on the relative importance of genetic and environmental influences on BDD symptoms, and the risk for co-existing psychopathology. Methods: Prevalence of BDD symptoms was determined by a validated cut-off on the Dysmorphic Concerns Questionnaire (DCQ) in three population-based twin cohorts at ages 15 (n = 6968), 18 (n = 3738), and 20–28 (n = 4671). Heritability analysis was performed using univariate model-fitting for the DCQ. The risk for co-existing psychopathology was expressed as odds ratios (OR). Results: The prevalence of clinically significant BDD symptoms was estimated to be between 1 and 2% in the different cohorts, with a significantly higher prevalence in females (1.3–3.3%) than in males (0.2–0.6%). The heritability of body dysmorphic concerns was estimated to be 49% (95% CI 38–54%) at age 15, 39% (95% CI 30–46) at age 18, and 37% (95% CI 29–42) at ages 20–28, with the remaining variance being due to non-shared environment. ORs for co-existing neuropsychiatric and alcohol-related problems ranged from 2.3 to 13.2. Conclusions: Clinically significant BDD symptoms are relatively common in adolescence and young adulthood, particularly in females. The low occurrence of BDD symptoms in adolescent boys may indicate sex differences in age of onset and/or etiological mechanisms. BDD symptoms are moderately heritable in young people and associated with an increased risk for co-existing neuropsychiatric and alcohol-related problems.

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KW - comorbidity

KW - heritability

KW - obsessive-compulsive disorder

KW - prevalence

KW - twin study

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U2 - 10.1017/S0033291718000375

DO - 10.1017/S0033291718000375

M3 - Article

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SN - 0033-2917

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EP - 8

JO - Psychological Medicine

JF - Psychological Medicine

ER -

Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study

Abstract

Keywords

UN SDGs

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