To Örebro University

Previous research indicates that body dysmorphic disorder (BDD) is associated with risk of suicidality. However, studies have relied on small and/or specialist samples and largely focused on adults, despite these difficulties commonly emerging in youth. Furthermore, the aetiology of the relationship remains unknown.

Two independent twin samples were identified through the Child and Adolescent Twin Study in Sweden, at ages 18 (N = 6027) and 24 (N = 3454). Participants completed a self-report measure of BDD symptom severity. Young people and parents completed items assessing suicidal ideation and suicide attempts. Logistic regression models tested the association between continuous scores of BDD symptoms and suicidality outcomes. Bivariate genetic models examined the aetiology of the association between BDD symptoms and a suicidality composite at both ages.

BDD symptoms were positively associated with suicidal ideation and suicide attempts at age 18 and 24. These associations generally remained significant after adjusting for depressive and anxiety symptoms. Genetic factors accounted for most of the covariance between BDD symptoms and suicidality (74.1% and 79.4% at ages 18 and 24, respectively), but with significant non-shared environmental influences (25.9% and 20.6% at ages 18 and 24, respectively).

BDD symptoms are associated with substantial risk of suicidal ideation and behaviours in late adolescence and early adulthood. This relationship is largely explained by common genetic liability, but non-shared environmental effects are also significant and could provide opportunities for prevention among those at high-risk.