(99) SEXUALITY, THE ULTIMATE ‘EXPOSURE OR ESCAPE’ FOR PATIENTS WITH BODY DYSMORPHIC DISORDER

Abstract Objectives In body dysmorphic disorder (BDD), anxiety for judgement of appearance plays a major role and is especially difficult in contact with others. In sexual engagement this is unavoidable. It is also known that sexuality is an essential part of quality of life and that for both healthcare providers and patients it is still a difficult topic to address. To date, there is no clear insight in how BDD interacts with sexuality. The aim of this study is to get a better understanding on how patients with BDD experience sexuality. Methods In the outpatient setting of the psychiatry department of the Amsterdam University Medical Center 15 patients (of mixed gender and sexual preference) underwent a semi-structured interview conducted by two researchers. The analyses took place by open coding and the results were discussed by all researchers involved. Results Sexuality is strongly influenced by the presence of BDD. During intercourse patients are trying to navigate on a vulnerable tension field that is created by opposite motives and feelings (such as avoidance versus willingness to engage or arousal versus disgust). Their sexuality is surrounded by rituals where there is little room for spontaneity. The success of the sexual experience depends mainly on the pleasure of the other person and can be immediately interrupted by a tactile or visual confrontation with the respective BDD focus. In the continuous stream of negative thoughts, there is either little contact with the body or it rather serves as a functional instrument that is used to get out of their head. All patients agree that discussing sexuality and using bodily exercises are important. Conclusions In this first qualitative study on sexuality in a diverse group of BDD patients, it became clear that sexuality is a topic full of tension. Sexuality should have a part in the treatment of patients with BDD. Conflicts of Interest There are no conflicts of interest.