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The Clinical Course of Body Dysmorphic Disorder in the Harvard/Brown Anxiety Research Project (HARP)

Bjornsson, Andri S. PhD*†; Dyck, Ingrid MPH; Moitra, Ethan PhD; Stout, Robert L. PhD; Weisberg, Risa B. PhD†‡; Keller, Martin B. MD; Phillips, Katharine A. MD*†

The Journal of Nervous and Mental Disease: January 2011 - Volume 199 - Issue 1 - p 55-57
doi: 10.1097/NMD.0b013e31820448f7
Brief Reports

This report prospectively examines the course of body dysmorphic disorder (BDD) for up to 8 years in a sample of 514 participants in the Harvard/Brown Anxiety Research Project, a naturalistic, longitudinal study of anxiety disorders. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) BDD was assessed with a reliable semi-structured measure. For participants with BDD, severity of BDD symptoms was assessed with the Longitudinal Interval Follow-up Evaluation Psychiatric Status Rating scale. At the initial assessment, 17 participants (3.3%; 95% confidence interval = 1.8%–4.8%) had current BDD; 22 (4.3%; 95% confidence interval = 2.6%–6.1%) had lifetime BDD. Participants with BDD had significantly lower Global Assessment Scale scores than those without BDD, indicating poorer functioning. The probability of full recovery from BDD was 0.76, and probability of recurrence, once remitted, was 0.14 over the 8 years. In conclusion, among individuals ascertained for anxiety disorders, the probability of recovering from BDD was relatively high and probability of BDD recurrence was low.

*Rhode Island Hospital, Providence, RI; and Departments of †Psychiatry and ‡Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI.

Supported by K23MH69595 (to R.B.W.), 5RO1MH51415-14 (to M.B.K.), and K24MH063975 (to K.A.P.).

Send reprint requests to Andri S. Bjornsson, PhD, Rhode Island Hospital, Coro Center West, 1 Hoppin St, Providence, RI 02903. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.