More than one in twenty girls aged 17 to 19 may have a body dysmorphic disorder (BDD), according to findings from the latest Mental Health of Children and Young People survey. The anxiety disorder, defined as being preoccupied with an aspect of personal appearance hugely out of proportion of any actual defect, can be debilitating and distressing, and has only recently gained recognition in the UK.
BDD usually onsets in adolescence but often goes unrecognised, and adolescents with the disorder may go on to experience suicidal thoughts. It is entirely treatable and features in the list of mental disorders used by researchers and clinicians in the United States (the fifth American Diagnostic and Statistical Manual, also called DSM-5). BDD is not in the current disorder catalogue used in Europe and much of the rest of the world, however it is under consideration for inclusion in the next volume of the International Classifications of Disease (ICD 11). We hope that this will mean BDD gains more recognition outside of the United States.
The latest Mental Health of Children and Young People survey was the first in the series to assess BDD, providing England’s first estimates of its prevalence in children and young people at one in a hundred 5 to 19 year olds overall (1.0%). It affects 1.8% of girls and 0.3% of boys. Rates were highest in girls aged 17 to 19 years old, with one in eighteen (5.6%) experiencing BDD at the time of the interview.
This is similar to rates found in other countries – 1.7% of adolescents aged 12 to 18 in Australia were identified with probable BDD, although no sex difference was found. A study in Germany also found a prevalence rate of 1.7%, although focused on an older sample, 14 to 99 year olds.
This survey is one of the first to measure the prevalence of BDD in children under the age of 12. Our data is consistent with previous perceptions that BDD may often onset in adolescence, particularly in girls. We found almost no evidence of it before age 11.
Body dysmorphic disorder presents affected children, and their families and schools, with major challenges. 17 to 19 year old girls have been highlighted as a high-risk group for this disorder, but also for the other types of emotional disorders covered on the survey. The reasons for this higher rate of emotional disorders in adolescent girls are likely to be due to a complex interaction of biological, psychological and social factors, however the extent of influence of different factors remains unclear. There is often speculation around the negative effects of social media on children and young people. This survey found that just over half of girls with a mental disorder (54.8%) compared themselves to others on social media, in contrast to 31.7% of those without a disorder. However, the link is still uncertain and more focussed and longitudinal research is needed to investigate these reasons. This report has highlighted the need for more awareness of the existence and severity of this disorder and into the best ways to respond.
The survey was published by NHS Digital and carried out by NatCen Social Research, in collaboration with the Office for National Statistics.