Magnitude and determinants of body dysmorphic disorder among female students in Saudi public secondary schools

OBJECTIVES: Recent estimates have indicated that the weighted community prevalence of body dysmorphic disorder (BDD) is rising. This study aimed to identify the prevalence and determinants of BDD among female adolescents in Jeddah, KSA. METHODS: A cross-sectional study was conducted among female students in governmental secondary schools. Students presenting with abnormal health conditions were excluded. A multi-stage stratified sampling technique was used to select the target number of students (N = 495). BDD screening was performed using a BDD questionnaire. RESULTS: The students’ mean (standard deviation) age was 16.78 (1.11) years, and the prevalence of BDD was 12.3% (95% confidence interval: 9.6–15.5%). The body parts associated with the most concern were the skin (18.4%), hair (10.7%), teeth (9.9%), and nose (9.5%). Psychosocial assessment showed that the body part of concern was associated with sadness in 20.6%, avoidance reactions in 17.6%, and problems in school, work, or other activities in 3.8% while playing a role in social relationships in 21.5%. The aspects associated with the highest risk included the skin (odds ratio (OR) = 8.33, p < 0.001), followed by body fat (OR = 8.17, p < 0.001) and the nose (OR = 7.35, p < 0.001). With the number of affected body parts, the prevalence of BDD increased from 21.7% (one body part) to 60%. CONCLUSIONS: In this study, BDD was a common, difficult-to-recognise disorder with a prevalence of one in eight female Saudi adolescents. It was associated with marked changes in social interactions, self-esteem, and quality of life.