Because no cross-cultural comparison studies of BDD have been performed, the disorder's prevalence and clinical features across cultures cannot be directly compared. However, case reports and series of BDD from around the world suggest that the disorder's clinical features are generally similar across cultures, and that culture appears to produce nuances and accents on a basically invariant, or universal, expression of BDD. (4,) It is unclear whether koro (a belief that one's penis is shrinking or retracting, which occurs primarily in Southeast Asia) is a form of BDD.
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