• [Show abstract] [Hide abstract]
    ABSTRACT: Body dysmorphic disorder (BDD) is defined as a preoccupation with an imagined or minimal defect in appearance. Virtually any body part can be the focus of concern, although preoccupations with the hair, nose and skin are particularly common. Associated features include repetitive and often ritualistic behaviours, such as mirror checking and requests for reassurance, as well as ideas or delusions of reference. The degree of impairment associated with the disorder is variable, but most patients experience significant functional impairment as a result of their concerns. While this often secret disorder has been described for more than a century and reported around the world, it has received little empirical investigation. Nonetheless, emerging data suggest that BDD is frequently a chronic disorder that usually begins during adolescence. Psychiatric hospitalisation and suicide attempts are common in patients with BDD. Disorders that are frequently comorbid include major depression, social phobia and obsessive-compulsive disorder. The prevalence of BDD among patients with other psychiatric disorders, such as atypical depression, obsessive-compulsive disorder and social phobia, appears to be relatively high. The majority of patients with BDD seek often costly nonpsychiatric therapies, such as surgical or dermatological interventions. These approaches are usually unsuccessful. In contrast, preliminary data from noncomparative studies suggest that serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are often, and perhaps preferentially, effective in the treatment of BDD. Other preliminary data suggest that cognitive-behavioural strategies may also be useful. There are virtually no data on treatment-resistant BDD, but certain pharmacological approaches including augmentation, combination and switching strategies are sometimes effective. Further investigation of all aspects of this understudied disorder is greatly needed. Aspects that require particular attention are the epidemiology, clinical features, relationship to other psychiatric disorders, biology and, ultimately, aetiology and treatment response.
    CNS Drugs 01/1995; 3(1). · 4.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Dysmorphophobia (body dysmorphic disorder), defined as a preoccupation with an imaginary or minimal defect in appearance, has been known for more than a century but has received relatively little empirical study. The authors investigated the demographics, phenomenology, course, associated psychopathology and family history in a series of 58 patients (34 men and 24 women) with the disorder. The patients were assessed with the Hopkins Symptom Checklist and two specially constructed instruments developed by the authors. The mean age at onset of body dysmorphic disorder was 17 (sd = 3.8) years and the average duration was 9 (sd = 5.3) years. The most common preoccupations were defects of the face, nose, genitals and legs. Seventy-nine percent of the patients reported excessive mirror checking and 53% reported attempts to camouflage their ‘deformities’. As a result of their symptoms, 89.6% avoided the usual social activities, 51.7% showed an impairment of their academic or job performance, 45% experienced suicidal ideation and 36% showed aggressive behaviour. Seventy-two percent of the patients had an associated lifetime diagnosis of a major mood disorder and 74% of an anxiety disorder. Body dysmorphic disorder has a generally chronic course, causes considerable distress and a serious impairment in many areas, and shows strong links with mood and obsessive-compulsive disorders.
    International Journal of Psychiatry in Clinical Practice 01/1997; 1(2):77-82. · 1.31 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Body dysmorphic disorder (BDD) can be a severe and often debilitating psychiatric disorder that has been largely under-recognized and underdiagnosed. Pharmacologic and nonpharmacologic treatment options are available but limited. This review aims to provide an updated overview of the psychopathology and epidemiology of BDD, with an emphasis on current pharmacologic and nonpharmacologic treatment options for BDD.
    Psychiatric Clinics of North America 09/2014; · 2.13 Impact Factor