formerly referred to as dysmorphophobia, tends to occur in young adults
equally in either gender. The patient becomes pre-occupied with a non-existent
or minimal cosmetic defect (nose, cleft chin, blemish, breast size)
and persistently seeks medical attention to fix it surgically. Some
clinicians feel it is a variant of obsessive-compulsive
disorder. Many do well with surgery, but some remain persistently
disgruntled. It is important to distinguish them from psychotic patients
and those with highly disturbed global and body self-images, since those
patients will not be improved by surgery.
Body Dysmorphic Disorder (BDD) therefore is characterized by certain
key and associated features, specifically preoccupying obsessions with
a particular body part that the person considers unattractive.
Cases of body dysmorphic disorder can range from relatively mild to
very severe. People with mild cases are bothered and distressed, and
their obsessions cause some degree of impairment.
The patient is preoccupied with an imagined defect of appearance or
is excessively concerned about a slight physical anomaly.
This preoccupation causes clinically important distress or impairs work,
social or personal functioning.
Another mental disorder (such as Anorexia
Nervosa) does not better explain the preoccupation.
or Sexual Dysfunction
Guilt or Obsession
Anxious or Fearful or Dependent
Some disorders display similar or sometimes even the same symptom. The
clinician, therefore, in his diagnostic attempt, has to differentiate
against the following disorders which one needs to be ruled out to establish
a precise diagnosis.
General Medical Condition.
Major Depressive Disorder.
Although we still
do not have a single clear cause for body dysmorphic disorder, authorities
believe that biological, psychological and perhaps even social or cultural
factors contribute to its origins.
and Psychotherapy [ See
Therapy Section ]:
therapy which includes education about BDD and its treatment, and specific
treatments to deal with faulty thoughts, assumptions ("cognition's")
and problematic behaviors. The cognitive aspects involve discovering,
challenging and changing the underlying negative thoughts and beliefs
the sufferer keeps thinking.
behavioral components usually focus on exposure and response prevention.
Exposure usually involves having the sufferer gradually learn to face
and confront the situations they fear the most, such as going into public
places or exposing their embarrassing body part to others' scrutiny
without hiding or camouflaging it. Response prevention involves getting
the sufferer to conscientiously and diligently refuse or avoid doing
the self-damaging behaviors they feel compelled to do, such as staring
endlessly into mirrors or picking at one's face. When sufferers are
able to delay such behaviors long enough, the impulse to do them sometimes
dies down, and these behaviors may be thwarted.
suggests that medication and cognitive-behavior therapies can complement
each other well. In addition to these treatments, family education and
counseling, to help family members understand what is going on and how
to help the sufferer, and group therapy or support for those with BDD
may be of benefit.
[ See Psychopharmacology
Section ] :
SRIs. These same SRI medications are also used to treat depression,
obsessive-compulsive disorder (OCD) and other anxiety conditions.