Screening College Students for Body Dysmorphic Disorder Using Dysmorphic Concern Questionnaire: A Cross Sectional Study Comparing Public Sector Medicaland Non-Medical Students in Punjab, Pakistan

Abstract

Background and Objectives: Body Dysmorphic disorder (BDD) is a psychiatric condition characterized by
preoccupation with an imagined flaw in appearance or slight defect in one's body. It is a disabling obsessivecompulsive spectrum disorder often goes unrecognized in clinical practice and found to be associated with
social anxiety, distress and suicidal tendency. The aim of this study was to screen public sector college
students for body dysmorphic disorder using a validated dysmorphic concern questionnaire® through an
online survey and describing family, peers and media influences in relation to its occurrence.
Methods: This descriptive, cross-sectional study was undertaken in two public sector medical colleges
(Lahore and Sialkot) and one public sector general education college (Sialkot) during November 2019 to June
2022.Overall, 378 students completed a validated 7-itemsDysmorphicConcernQuestionnaire (DCQ)®online.
Participants provided responses on a 4-point scale. They also responded to questions regarding social
pressures and media influencing the dysmorphic concern.ABDD score was computed as per method described
by Mancuso et al. and participants with score more than 14 were labelled as having BDD. Association
between family, peers andmedia influenceswithBDDscorewas analyzed using logistic regression technique in
SPSS version 25.®
Results: Of 378 participants, 251 (66%) were medical students and 127 (34%) were general education
students. About 1.3% medical students and 5.0 % non-medical students were classified having potential body
dysmorphic disorder respectively. Adjusted odds ratio comparing medical and non-medical students for
BDD is 4.4 (95% CI: 1.2-15.9; p=0.02) with higher odds of BDD observed for those aged 18-20 years
(OR=3.3) and in females (OR=1.1, 95% CI=0.4-2.8; p=0.83).
Conclusion: BDD is comparatively frequent in non-medical female students aged 18-20 years. Family and
peer pressure alongside the influences from social, print and electronic media had considerable effect on nonmedical students comparatively and may contribute the occurrence of body dysmorphic disorder.