Body dysmorphic disorder:
clinical aspects and treatment strategies
by
Phillips KA
Body Dysmorphic Disorder Program,
Butler Hospital,
Providence, RI 02906, USA.
Bull Menninger Clin 1998 Fall;62(4 Suppl A):A33-48
ABSTRACT
Body dysmorphic disorder (BDD), a distressing and impairing preoccupation
with an imagined or slight defect in appearance, is an "OCD-spectrum disorder"
that appears to be relatively common. BDD often goes unrecognized and
undiagnosed, however, due to patients' reluctance to divulge their symptoms
because of secrecy and shame. Any body part can be the focus of concern (most
often, the skin, hair, and nose), and most patients engage in compulsive
behaviors, such as mirror checking, camouflaging, excessive grooming, and skin
picking. Approximately half are delusional, and a majority experience ideas or
delusions of reference. Nearly all patients suffer some impairment in
functioning as a result of their symptoms, some to a debilitating degree.
Psychiatric hospitalization, suicidal ideation, and suicide attempts are
relatively common. While treatment data are preliminary at this time, selective
serotonin reuptake inhibitors (SSRIs) appear to often be effective for BDD, even
if symptoms are delusional. Cognitive-behavioral therapy is another promising
approach. While much remains to be learned about BDD, it is important that
clinicians screen patients for this disorder and accurately diagnose it, as
available treatments are very promising for those who suffer from this
distressing and sometimes disabling disorder.
BDD
OCD
SSRIs
Serotonin
Self-mutilation
Slimming drugs
Eating disorders
Evolution and emotion
The evolution of suicide
Body dysmorphic disorder (BDD)