All individuals with BDD should be carefully assessed and monitored for suicidality. Individuals with BDD have a markedly increased risk for suicidality. Approximately 80% of those with BDD report that they have experienced suicidal thoughts, and about one in four or more have attempted suicide. For the majority of these individuals, BDD symptoms are the primary reason for their suicidal thinking and behavior.
Suicide attempts appear to be even more common in youth and in Veterans with BDD. And in a small study on muscle dysmorphia in men (i.e., preoccupation with having an insufficiently large or muscular build, which often results in excessive weight lifting, dieting, and use of potentially dangerous drugs such as anabolic steroids), 50% reported a lifetime suicide attempt. Multiple studies have shown that suicidality is significantly more common in individuals with BDD than in those with OCD.
The presence of comorbid major depressive disorder is associated with a significantly increased risk of suicidal ideation in individuals with BDD. And the presence of comorbid post-traumatic stress disorder (PTSD) or a substance use disorder is associated with a significantly increased risk of attempting suicide. More severe BDD symptoms are significantly associated with an increased probability of both suicidal ideation and suicide attempts.
Very little research has been done on completed suicide in people with BDD, but available data indicate that those with BDD have a markedly elevated risk of committing suicide. The risk of suicide may be even higher than for individuals with major depressive disorder, anorexia nervosa, and bipolar disorder. Thus, clinicians must assess for suicidal ideation if BDD is suspected.