Psychocutaneous Dan

Question 1

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

Answer 1

True

Question 2

body dysmorphic disorder affects 12% of the population

Answer 2

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

Question 3

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

Answer 3

False 30%

Question 4

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

Answer 4

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

Question 5

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

Answer 5

FalseUp to 40%

Question 6

substance abuse is common in those with body dysmorphic disorder

Answer 6

True40%

Question 7

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

Answer 7

True40% have another BDD

Question 8

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

Answer 8

False>5% have a parasite infestation

Question 9

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

Answer 9

True

Question 10

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

Answer 10

FalseLate diagnosis often >10 years as pts are secretive

Question 11

Body dysmorphic disorder gets better after surgery

Answer 11

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

Question 12

Body dysmorphic disorder symptoms last 11-18 years typically

Answer 12

True

Question 13

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

Answer 13

True

Question 14

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

Answer 14

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

Question 15

Psychological therapies are helpful for Body dysmorphic disorder

Answer 15

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

Question 16

80% of childhood cases of Neurotic excoriations resolve before adulthood

Answer 16

Falsealmost half continue into adulthood

Question 17

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

Answer 17

Falseoccurs in almost 50% of women

Question 18

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

Answer 18

True

Question 19

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

Answer 19

FalseWomen age 30-50 have the most destructive picking

Question 20

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

Answer 20

True

Question 21

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

Answer 21

True

Question 22

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

Answer 22

True

Question 23

Problems with neurotic excoriations last 11-18 years typically

Answer 23

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

Question 24

Trichotillomania is most common in the elderly

Answer 24

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

Question 25

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

Answer 25

True

Question 26

Preschool trichotillomania is more common in girls

Answer 26

Falsemore common in boys

Question 27

Dermatitis artefacta is twice as common in adult women as men

Answer 27

False4-20x more common women

Question 28

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

Answer 28

Truebooks say both M=F and more in girls

Question 29

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

Answer 29

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

Question 30

60% of Dermatitis arefacta pts have somatisation disorder and hypochondria

Answer 30

False20% do

Question 31

Delusions of parasitosis has average age of onset of 60 years

Answer 31

True

Question 32

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

Answer 32

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

Question 33

There is no real defect in body dysmorphic disorder

Answer 33

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

Question 34

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

Answer 34

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

Question 35

Narcissistic personality disorder is common in those with body dysmorphic disorder

Answer 35

False other PD common esp avoidant

Question 36

Neurodermatitis is the same as neurotic excoriations

Answer 36

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

Question 37

Neurotic excoriations are common in the elderly

Answer 37

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

Question 38

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

Answer 38

True