Psychocutaneous Dan Flashcards
body dysmorphic disorder is 2-3x more common in women
True
body dysmorphic disorder affects 12% of the population
Falsepoint prevalence 1%but 12% in derm clinics (10-14)
OCD is seen in 80% of those with body dysmorphic disorder
False 30%
Depression risk is 80% in those with Body dysmorphic disorder and suicidality is common
Truealso;up to 80% have suicideal ideation25% make suicide attempts
social phobia is seen in >50% of those with body dysmorphic disorder
FalseUp to 40%
substance abuse is common in those with body dysmorphic disorder
True40%
anorexia nervosa patients often have body dysmorphic disorder related to things other than their weight
True40% have another BDD
20% of delusions of parasitosis pts actually have a parasite infestation
False>5% have a parasite infestation
> 10% of delusions of parasitosis pts have folie a deux
True
Body dysmorphic disorder is often diagnosed within a few months of onset
FalseLate diagnosis often >10 years as pts are secretive
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
Body dysmorphic disorder symptoms last 11-18 years typically
True
If pts have sub-Body dysmorphic disorder and have cosmetic treatment, 50% will still develop BDD
True
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
Psychological therapies are helpful for Body dysmorphic disorder
TrueCBT can relieve stress and symptoms by >75%Also trySupportive psychotherapyNarrative therapy
80% of childhood cases of Neurotic excoriations resolve before adulthood
Falsealmost half continue into adulthood
In 15% of women with neurotic excoriations increased picking coincides with menstrual periods
Falseoccurs in almost 50% of women
Diagnosis of neurotic excoriations is often delayed by up to 10 years
True
Women in their 20s with neurotic excoriations have the most destructive picking habits
FalseWomen age 30-50 have the most destructive picking
2 thirds of pts with neurotic excoriation suse make up and clothes to conceal the skin features
True
People with neurotic excoriations are rigid and obsessional and exacerbations are linked to stress
True
Depression is common in neurotic excoriations and 40% avoid social situations
True
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
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
Adult or adolescent trichotillomania is at least 4x more common in women than men
True
Preschool trichotillomania is more common in girls
Falsemore common in boys
Dermatitis artefacta is twice as common in adult women as men
False4-20x more common women
Dermatitis artefacta can occur in children as young as 5 with a female preponderance
Truebooks say both M=F and more in girls
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
60% of Dermatitis arefacta pts have somatisation disorder and hypochondria
False20% do
Delusions of parasitosis has average age of onset of 60 years
True
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
There is no real defect in body dysmorphic disorder
False may or may not be a real abdnormality often worse BDD if there is
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
Narcissistic personality disorder is common in those with body dysmorphic disorder
False other PD common esp avoidant
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
Neurotic excoriations are common in the elderly
False occurs in children esp under 10 and adults up to middle age but not elderly
Surgery or other treatments are appropriate in some body dysmorphic disorder patients but psychiatric referral for SSRIs and CBT are mainstays of treatment
True
