Body dysmorphic symptoms in autism and attention-deficit hyperactivity disorder: A comorbidity study

Body dysmorphic disorder (BDD) is a persistently under-recognised psychiatric condition. Evidence suggests a degree of shared cognitive dysfunction and clinical presentation of BDD with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The current study is the first to investigate the co-occurrence of BDD, ASD and ADHD in a large online community sample. Utilising data from an online survey, we investigated the comorbidity frequency of BDD, ASD and ADHD, as well as the presence of possible undiagnosed BDD in these neurodevelopmental populations (N = 6844). Individuals with BDD did not report a higher frequency of ASD or ADHD comorbidity than those without BDD. However, individuals with neurodevelopmental diagnoses were significantly more likely to have possible undiagnosed BDD than those without a neurodevelopmental diagnosis (ASD adjusted odds ratio [AOR] = 3.55, ADHD AOR = 2.45). These preliminary findings cautiously suggest that elevated body image concern and possible BDD in ASD and ADHD are potentially missed or misattributed to individuals' neurodevelopmental diagnoses without further investigation.