Abstract
Background: Body dysmorphic disorder (BDD) symptoms are common in dermatology settings globally but remain understudied in African populations, particularly in Nigeria. This study described the pattern and distribution of BDD symptoms using the Body Dysmorphic Disorder Questionnaire (BDDQ) among patients attending a dermatology clinic in Kano.
Methods: A cross-sectional descriptive study was conducted with 375 dermatology outpatients using systematic sampling. The BDDQ was used to assess appearance concern, preoccupation, distress, functional impairment, avoidance behaviours, and time spent thinking about appearance. Only participants who endorsed both appearance concern and preoccupation (n=87) proceeded to complete the impairment and time items. Descriptive statistics, frequencies, and chi-square tests (with Fisher’s test where appropriate) were used to explore socio-demographic variations.
Results: Appearance concern was reported by 24.8% (93/375), while 23.2% (87/375) endorsed both concern and preoccupation. Among the 87 preoccupied participants, emotional distress was reported by 75.9%, functional impairment by 85.1%, avoidance behavior by 55.2%, and severe impairment by 47.1%. Significant associations were found between appearance preoccupation and female gender (p=0.001), lower education (p<0.001), and unemployment (p<0.001). Severe impairment was significantly more common in younger adults (p<0.001), females (p<0.001), and those not currently married (p=0.004).
Conclusions: Body dysmorphic disorder symptoms are prevalent and highly impairing among dermatology outpatients in northern Nigeria. Females, younger adults, and socioeconomically disadvantaged groups reported higher levels of preoccupation and severe impairment. Routine screening with brief tools such as the BDDQ is recommended to facilitate early identification and integrated psycho-dermatological care.

Key words: Body dysmorphic disorder symptoms; BDDQ; dermatology; Nigeria; appearance preoccupation; functional impairment