Body dysmorphic disorder: Clinical aspects and treatment strategies

Journal/Book: Bull Menninger Clin. 1998; 62: Box 829, Topeka, KS 66601. Menninger Foundation. A33-A48.

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 cart 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 (SSRls) 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.

Note: Article Phillips KA, Butler Hosp, Outpatient Serv, 345 Blackstone Blvd, Providence,RI 02906 USA

Keyword(s): OBSESSIVE-COMPULSIVE DISORDER; MAJOR DEPRESSION; ANXIETY DISORDERS; SPECTRUM DISORDER; IMAGINED UGLINESS; DYSMORPHOPHOBIA; SEROTONIN; THERAPY; SCALE; RELIABILITY

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