Evidence map›Paper›PMID 40578059›Full record

SynthesisJournal of psychiatric research2025

Empirically informed symptom severity cutoffs for body dysmorphic disorder.

David Mataix-Cols, Philip Andersson, Daniel Rautio, Oskar Flygare, Jennifer L Greenberg, Susanne S Hoeppner, Hilary Weingarden, Amita Jassi, Benedetta Monzani, Eric Hollander and 8 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in Journal of psychiatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Detecting body dysmorphic disorder in the age of algorithms.Frontiers in artificial intelligence · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

David Mataix-ColsCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden; Department of Clinical Sciences, Lund, Lund University, Sweden. Electronic address: david.mataix.cols@ki.se.
Philip AnderssonCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Daniel RautioCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Oskar FlygareCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Jennifer L GreenbergMassachusetts General Hospital and Harvard Medical School, Boston, USA.
Susanne S HoeppnerMassachusetts General Hospital and Harvard Medical School, Boston, USA.
Hilary WeingardenMassachusetts General Hospital and Harvard Medical School, Boston, USA.
Amita JassiNational and Specialist OCD, BDD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
Benedetta MonzaniNational and Specialist OCD, BDD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
Eric HollanderAlbert Einstein College of Medicine, Bronx, NY, USA.
David CastleUniversity of Tasmania and Centre for Mental Health Service Innovation, Statewide Mental Health Service, Tasmania, Australia.
Georgina KrebsNational and Specialist OCD, BDD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK; Research Department of Clinical, Educational & Health Psychology, University College London, UK.
Susan L RossellCentre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.
Sabine WilhelmMassachusetts General Hospital and Harvard Medical School, Boston, USA.
Christian RückCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Katharine A PhillipsRhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA; New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA.
Lorena Fernández de la CruzCenter for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Matti CervinDepartment of Clinical Sciences, Lund, Lund University, Sweden.

Funding

SUPPORT FOR THE ROSE F KENNEDY IDDRC P50P50HD105352 · NICHD · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI SOPHIE MOLHOLM, Steven Upshaw Walkley · 2021 to 2026
$7.0M
Pharmacotherapy Relapse Prevention in BDDR01MH072917 · NIMH · BUTLER HOSPITAL (PROVIDENCE, RI) · PI PHILLIPS, KATHARINE ANNE · 2005 to 2009
$1.5M
Pharmacotherapy Relapse Prevention in Body Dysmorphic DisorderR01MH072854 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI WILHELM, SABINE · 2005 to 2009
$1.5M
CBT Treatment Development for Body Dysmorphic DisorderR34MH070490 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI WILHELM, SABINE · 2004 to 2006
$621k
NICHD NIH HHS P50 HD105352NIMH NIH HHS R01 MH072854NIMH NIH HHS R01 MH072917NIMH NIH HHS R34 MH070490
6 · The paper itself

Abstract

backgroundSymptom severity cutoffs for body dysmorphic disorder (BDD) are lacking, hindering communication between professionals and with the patient community.

methodWe pooled data from 11 clinical trials or high-quality cohort studies from specialist clinics, totaling 804 individuals with BDD (80 % girls/women, 67 % adults). All participants had baseline scores on the adult or adolescent versions of the Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS) and the Clinical Global Impressions-Severity scale (CGI-S). Receiver-operating characteristic analyses were used to identify BDD-YBOCS severity cutoffs, using the CGI-S as the benchmark measure. The classification performance of the cutoffs was evaluated in a holdout sample, consisting of 20 % of randomly selected participants.

resultsNo participants had subclinical symptoms and the cutoff for clinical versus subclinical cases was not computed. A BDD-YBOCS score ≥24 distinguished moderate from mild cases (area under the curve [AUC] = 0.72 [0.64-0.81]; accuracy: 77 %), a score ≥30 distinguished severe from moderate cases (AUC = 0.83 [0.90-0.87]; accuracy: 77 %), and a score ≥37 distinguished extreme from severe cases (AUC = 0.82 [0.77-0.87]; accuracy: 80 %). The classification performance of the cutoffs was modest in the holdout sample (62 %), but consistent cutoffs were found across sexes/genders, age groups (children and adults), and participants from Europe and the United States.

conclusionThese BDD-YBOCS severity cutoffs can be used for clinical and research purposes across different populations but should not be used as the sole basis for important clinical decisions affecting individual patients. The boundary between subclinical and clinical BDD will require further study.

Indexed as

Body Dysmorphic DisordersPatient AcuityAdolescentAdultFemaleHumansMaleYoung Adult

Identifiers

PMID40578059
PMCPMC12912709

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.