Cultural Variations of Body Dysmorphic Disorder among Youth in Educational Institutions

Abstract

Background: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by excessive concern with perceived physical defects, often leading to social, academic, and psychological impairment. Global prevalence ranges from 0.7–2.4% in community samples and is higher in clinical populations, but data from South Asia, particularly in culturally diverse cities such as Karachi, remain scarce. Sociocultural norms, gender expectations, and institutional environments may play critical roles in shaping vulnerability to BDD. Objective: To estimate the prevalence of BDD among students aged 14–25 years in Karachi and to examine its associations with cultural, demographic, and institutional factors including religion, ethnicity, gender, and educational setting. Methods: A descriptive cross-sectional observational study was conducted among 183 students recruited through convenience sampling from schools, colleges, universities, and coaching centers. The Body Dysmorphic Disorder Questionnaire (BDDQ) was administered, and associations with demographic and cultural variables were analyzed using chi-square tests and odds ratios with 95% confidence intervals. Ethical approval and informed consent were obtained. Results: BDD prevalence was 92.9% (n=171). Religion (p=0.001) and institution type (p<0.001) were significantly associated with BDD, with Muslim students (OR=3.62, 95% CI: 1.12–11.67) and university students (OR=4.85, 95% CI: 1.58–14.87) showing elevated odds. No significant associations were observed for ethnicity (p=0.834) or gender (p=0.388). Conclusion: The study highlights exceptionally high BDD prevalence among Karachi students, with institutional and religious factors exerting the greatest influence. Findings underscore the urgent need for culturally sensitive screening, awareness programs, and preventive interventions in educational environments.