order have many risk factors for completed suic ide, such as high rates of suicidal ideation
and suicide attempts, demographic characterist ics associated with suicide, and high rates
of comorbid major depressive disorder. 
Functional Consequences of 
Body Dysmorphic Disorder
Nearly all individuals with body dysmorphic disorder experience impaired psychosocial
functioning because of their appearance concerns. Impairment can range from moderate
(e.g., avoidance of some social situations) to  extreme and incapacitating (e.g., being com-
pletely housebound). On average, psychosocial functioning and quality of life are mark-
edly poor. More severe body dysmorphic diso rder symptoms are associated with poorer
functioning and quality of life. Most individu als experience impairment in their job, aca-
demic, or role function ing (e.g., as a parent or caregive r), which is often severe (e.g., per-
forming poorly, missing school  or work, not working). About 20% of youths with body
dysmorphic disorder report dropping out of school primarily because of their body dys-
morphic disorder symptoms. Impair ment in social functioning (e.g., social activities, rela-
tionships, intimacy), includ ing avoidance, is common. In dividuals may be housebound
because of their body dysmor phic disorder symptoms, some times for years. A high pro-
portion of adults and adolescents have been psychiatrically hospitalized.
Differential Diagnosis
Normal appearance concerns and cl early noticeable physical defects. Body dysmor-
phic disorder differs from normal appearance  concerns in being characterized by exces-