Abstract：
BACKGROUND: Previous research indicates an association of body dysmorphic disorder (BDD) with suicidal thoughts and behaviours, but has largely relied on small cohorts drawn from specialist clinics.
METHODS: Anonymised health-records from the South London and Maudsley NHS Foundation Trust between 2007 and 2019 were systematically searched using the Clinical Record Interactive Search data system.
RESULTS: 298 patients diagnosed with BDD between age 12 and 65 years were identified. 206 (69 %) had experienced lifetime suicidal ideation. 149 (50 %) had recorded lifetime acts of self-harm or suicide attempts, most commonly involving cutting and self-poisoning. Rates of self-harm/suicide attempts were similar in those diagnosed before or after 18 years. Comorbid depression was associated with suicidal ideation (OR: 4.26 95% CI 2.07-9.72). Additionally, comorbid depression, OCD and anxiety were all associated with self-harm/suicide attempts (OR: 1.94 95% CI 1.15-3.31, OR: 1.99 95% CI 1.09-3.73, and OR: 1.93 95% CI 1.09-3.45, respectively). The presence of two or more psychiatric comorbidities was associated with a significantly elevated likelihood of suicidal ideation (OR: 7.06 95% CI 2.80-21.7) and self-harm/suicide attempts (OR: 4.62 95% CI 2.32-9.62).
CONCLUSIONS: It is likely that BDD was under-diagnosed in the cohort, and those identified may not be representative. Additionally, the frequency and detail with which suicidal thoughts and behaviours were assessed varied and may also represent underestimates.
CONCLUSIONS: Suicidal ideation and self-harm/suicide attempts are common among individuals with BDD accessing mental health services. Psychiatric comorbidity and suicidal ideation should be assessed in all BDD patients.
METHODS: Anonymised health-records from the South London and Maudsley NHS Foundation Trust between 2007 and 2019 were systematically searched using the Clinical Record Interactive Search data system.
RESULTS: 298 patients diagnosed with BDD between age 12 and 65 years were identified. 206 (69 %) had experienced lifetime suicidal ideation. 149 (50 %) had recorded lifetime acts of self-harm or suicide attempts, most commonly involving cutting and self-poisoning. Rates of self-harm/suicide attempts were similar in those diagnosed before or after 18 years. Comorbid depression was associated with suicidal ideation (OR: 4.26 95% CI 2.07-9.72). Additionally, comorbid depression, OCD and anxiety were all associated with self-harm/suicide attempts (OR: 1.94 95% CI 1.15-3.31, OR: 1.99 95% CI 1.09-3.73, and OR: 1.93 95% CI 1.09-3.45, respectively). The presence of two or more psychiatric comorbidities was associated with a significantly elevated likelihood of suicidal ideation (OR: 7.06 95% CI 2.80-21.7) and self-harm/suicide attempts (OR: 4.62 95% CI 2.32-9.62).
CONCLUSIONS: It is likely that BDD was under-diagnosed in the cohort, and those identified may not be representative. Additionally, the frequency and detail with which suicidal thoughts and behaviours were assessed varied and may also represent underestimates.
CONCLUSIONS: Suicidal ideation and self-harm/suicide attempts are common among individuals with BDD accessing mental health services. Psychiatric comorbidity and suicidal ideation should be assessed in all BDD patients.
摘要：
背景：先前的研究表明身体畸形障碍（BDD）与自杀念头和行为有关，但在很大程度上依赖于从专科诊所抽调的小群。
方法：使用临床记录交互式搜索数据系统系统地搜索了2007年至2019年来自伦敦南部和莫兹利NHS基金会信托的匿名健康记录。
结果：298名诊断为年龄在12至65岁之间的BDD患者被确定。206人(69%)有终生自杀意念。149人（50%）有终生自残或自杀未遂的记录，最常见的是切割和自我中毒。在18年之前或之后诊断出的自我伤害/自杀企图的比率相似。共患抑郁症与自杀意念相关(OR:4.2695CI2.07-9.72)。此外,抑郁症合并症，强迫症和焦虑都与自我伤害/自杀企图有关（OR：1.9495CI1.15-3.31，OR：1.9995CI1.09-3.73和OR：1.9395CI1.09-3.45）。两种或两种以上精神病合并症的存在与自杀意念(OR:7.0695CI2.80-21.7)和自残/自杀未遂(OR:4.6295CI2.32-9.62)的可能性显著升高相关。
结论：在队列中BDD可能被诊断不足，那些被识别的人可能没有代表性。此外,评估自杀念头和自杀行为的频率和细节各不相同，也可能代表低估。
结论：自杀意念和自残/自杀企图在获得精神卫生服务的BDD患者中很常见。应评估所有BDD患者的精神病合并症和自杀意念。
方法：使用临床记录交互式搜索数据系统系统地搜索了2007年至2019年来自伦敦南部和莫兹利NHS基金会信托的匿名健康记录。
结果：298名诊断为年龄在12至65岁之间的BDD患者被确定。206人(69%)有终生自杀意念。149人（50%）有终生自残或自杀未遂的记录，最常见的是切割和自我中毒。在18年之前或之后诊断出的自我伤害/自杀企图的比率相似。共患抑郁症与自杀意念相关(OR:4.2695CI2.07-9.72)。此外,抑郁症合并症，强迫症和焦虑都与自我伤害/自杀企图有关（OR：1.9495CI1.15-3.31，OR：1.9995CI1.09-3.73和OR：1.9395CI1.09-3.45）。两种或两种以上精神病合并症的存在与自杀意念(OR:7.0695CI2.80-21.7)和自残/自杀未遂(OR:4.6295CI2.32-9.62)的可能性显著升高相关。
结论：在队列中BDD可能被诊断不足，那些被识别的人可能没有代表性。此外,评估自杀念头和自杀行为的频率和细节各不相同，也可能代表低估。
结论：自杀意念和自残/自杀企图在获得精神卫生服务的BDD患者中很常见。应评估所有BDD患者的精神病合并症和自杀意念。
