Body dysmorphic disorder is common in adolescents referred to CAMHS, but is not diagnosed
Submitted by Eleni Frisira
Body dysmorphic disorder (BDD) is when someone worries so much about how they look that it takes over their life. What they see is usually something others barely notice, but the worry can be constant and very upsetting. These difficulties often begin around ages 12–13, but diagnosis usually comes much later, if at all.
Child and Adolescent Mental Health Services (CAMHS) are the NHS services that young people are referred to when their difficulties need more support than a GP can give.
We studied 307 young people aged 11–17 with emotional difficulties referred to CAMHS in England, as part of the STADIA trial. They and/or their parents/carers completed a questionnaire (the DAWBA) which estimates how likely someone is to meet criteria for a range of conditions.
About 6 in 100 young people were rated as probably having BDD, with a further 31 in 100 as possibly having it. However, no young people received a BDD diagnosis from a clinician within the next 12 months. Those with probable BDD were mostly girls, and around three quarters also scored very highly for depression and generalised anxiety. Half had thought about harming themselves in the previous six months and a third had done so. A year later, reports of self-harm were even more frequent. Despite this, they were no more likely than other referred young people to have their referral accepted by CAMHS or to be offered treatment.
I’m a young person – what does this mean for me?
Worrying about how you look is common. But sometimes it goes further and starts to take over your life - that’s what BDD is. If that's happening to you, you're not the only one. So it's worth sharing it with your parents, teachers or the clinicians you meet, even if you feel embarrassed or think it sounds trivial. It isn't, and it can be treated.
I’m a clinician – what does this mean for me?
Young people rarely raise appearance concerns unless asked, and parents often don't know how bad things have got. Where a young person presents with emotional difficulties, asking directly is a small change that could pick up a treatable condition, and a risk, that would otherwise be missed.