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Flashcards in Psychocutaneous Dan Deck (38):
1

body dysmorphic disorder is 2-3x more common in women

True

2

body dysmorphic disorder affects 12% of the population

Falsepoint prevalence 1%but 12% in derm clinics (10-14)

3

OCD is seen in 80% of those with body dysmorphic disorder

False 30%

4

Depression risk is 80% in those with Body dysmorphic disorder and suicidality is common

Truealso;up to 80% have suicideal ideation25% make suicide attempts

5

social phobia is seen in >50% of those with body dysmorphic disorder

FalseUp to 40%

6

substance abuse is common in those with body dysmorphic disorder

True40%

7

anorexia nervosa patients often have body dysmorphic disorder related to things other than their weight

True40% have another BDD

8

20% of delusions of parasitosis pts actually have a parasite infestation

False>5% have a parasite infestation

9

>10% of delusions of parasitosis pts have folie a deux

True

10

Body dysmorphic disorder is often diagnosed within a few months of onset

FalseLate diagnosis often >10 years as pts are secretive

11

Body dysmorphic disorder gets better after surgery

FalseAfter cosmetic surgery or other treatment 90% of these pts don’t think it helpedand 80% were dissatisfied with treatment and often think they look worseEven if result of the procedure is the best that could be expected pts may think they look even worse than beforeMany who initially appear happy with the treatment outcome report being dissatisfied 5 years later

12

Body dysmorphic disorder symptoms last 11-18 years typically

True

13

If pts have sub-Body dysmorphic disorder and have cosmetic treatment, 50% will still develop BDD

True

14

Most pts with Body dysmorphic disorder improve with SSRIs and relapse is rare

Flase>60% of patients improve - trueBut 80% relapse at discontinuation so need to continue long term – at least a year

15

Psychological therapies are helpful for Body dysmorphic disorder

TrueCBT can relieve stress and symptoms by >75%Also trySupportive psychotherapyNarrative therapy

16

80% of childhood cases of Neurotic excoriations resolve before adulthood

Falsealmost half continue into adulthood

17

In 15% of women with neurotic excoriations increased picking coincides with menstrual periods

Falseoccurs in almost 50% of women

18

Diagnosis of neurotic excoriations is often delayed by up to 10 years

True

19

Women in their 20s with neurotic excoriations have the most destructive picking habits

FalseWomen age 30-50 have the most destructive picking

20

2 thirds of pts with neurotic excoriation suse make up and clothes to conceal the skin features

True

21

People with neurotic excoriations are rigid and obsessional and exacerbations are linked to stress

True

22

Depression is common in neurotic excoriations and 40% avoid social situations

True

23

Problems with neurotic excoriations last 11-18 years typically

FalseOften resolves eventually – takes longer if it has been going for longer NB Body dysmorphic disorder lasts 11-18 years

24

Trichotillomania is most common in the elderly

False2 peaks;o Childhood more common - age 5-12 or sometimes preschoolo Chronic adult form – often starts in adolescence or early adulthood

25

Adult or adolescent trichotillomania is at least 4x more common in women than men

True

26

Preschool trichotillomania is more common in girls

Falsemore common in boys

27

Dermatitis artefacta is twice as common in adult women as men

False4-20x more common women

28

Dermatitis artefacta can occur in children as young as 5 with a female preponderance

Truebooks say both M=F and more in girls

29

Dermatitis arefacta can affect any age from 5 and has 2 major peaks in adolescets and women under 30

TrueAlso smaller group of older mainly male pts with more subtle skin lesions

30

60% of Dermatitis arefacta pts have somatisation disorder and hypochondria

False20% do

31

Delusions of parasitosis has average age of onset of 60 years

True

32

Delusions of parasitosis affects men and women equally under age 60 but women 3x more after age 60

Falseage 50 is the cut off for more women than menbut ave age of onset is 60

33

There is no real defect in body dysmorphic disorder

False may or may not be a real abdnormality often worse BDD if there is

34

Pts with body dysmorphic disorder are more likely to have schizophrenia or dementia than an organic cause

True organic cause very unlikely can be schizophrenia or dementia but not common

35

Narcissistic personality disorder is common in those with body dysmorphic disorder

False other PD common esp avoidant

36

Neurodermatitis is the same as neurotic excoriations

False In neurodermatitis pt has irresistible itching which has led to the itch-scratch cycle becoming autonomous and there are resultant skin changes – usually LSC but often can be prurigo nodularis. Should look for an underlying local or systemic cause of pruritus In neurotic excoriations there is anxiety related skin scratching and picking. May or may not be real or imagined itch. Acne excoriee is a variant

37

Neurotic excoriations are common in the elderly

False occurs in children esp under 10 and adults up to middle age but not elderly

38

Surgery or other treatments are appropriate in some body dysmorphic disorder patients but psychiatric referral for SSRIs and CBT are mainstays of treatment

True