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. 2004 Feb;80(940):67–71. doi: 10.1136/pmj.2003.015289

Body dysmorphic disorder

D Veale 1
PMCID: PMC1742928  PMID: 14970291

Abstract

Body dysmorphic disorder (BDD) is defined as a preoccupation with an "imagined" defect in one's appearance. Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive. The preoccupation is associated with many time consuming rituals such as mirror gazing or constant comparing. BDD patients have a distorted body image, which may be associated with bullying or abuse during childhood or adolescence. Such patients have a poor quality of life, are socially isolated, depressed, and at high risk of committing suicide. They often have needless dermatological treatment and cosmetic surgery. The condition is easily trivialised and stigmatised. There is evidence for the benefit of cognitive behaviour therapy and selective serotonin reuptake inhibitors in high doses for at least 12 weeks, as in the treatment of obsessive-compulsive disorder. There is no evidence of any benefit of antipsychotic drugs or other forms of psychotherapy.

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Selected References

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  1. Albertini R. S., Phillips K. A. Thirty-three cases of body dysmorphic disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1999 Apr;38(4):453–459. doi: 10.1097/00004583-199904000-00019. [DOI] [PubMed] [Google Scholar]
  2. Bohne Antje, Keuthen Nancy J., Wilhelm Sabine, Deckersbach Thilo, Jenike Michael A. Prevalence of symptoms of body dysmorphic disorder and its correlates: a cross-cultural comparison. Psychosomatics. 2002 Nov-Dec;43(6):486–490. doi: 10.1176/appi.psy.43.6.486. [DOI] [PubMed] [Google Scholar]
  3. Bohne Antje, Wilhelm Sabine, Keuthen Nancy J., Florin Irmela, Baer Lee, Jenike Michael A. Prevalence of body dysmorphic disorder in a German college student sample. Psychiatry Res. 2002 Jan 31;109(1):101–104. doi: 10.1016/s0165-1781(01)00363-8. [DOI] [PubMed] [Google Scholar]
  4. Brunswick R. M. En supplément à l'"Histoire d'une névrose infantile" de Freud. Rev Fr Psychanal. 1971 Jan;35(1):5–46. [PubMed] [Google Scholar]
  5. Faravelli C., Salvatori S., Galassi F., Aiazzi L., Drei C., Cabras P. Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychiatr Epidemiol. 1997 Jan;32(1):24–29. doi: 10.1007/BF00800664. [DOI] [PubMed] [Google Scholar]
  6. Ishigooka J., Iwao M., Suzuki M., Fukuyama Y., Murasaki M., Miura S. Demographic features of patients seeking cosmetic surgery. Psychiatry Clin Neurosci. 1998 Jun;52(3):283–287. doi: 10.1046/j.1440-1819.1998.00388.x. [DOI] [PubMed] [Google Scholar]
  7. Neziroglu Fugen, Khemlani-Patel Sony. A review of cognitive and behavioral treatment for body dysmorphic disorder. CNS Spectr. 2002 Jun;7(6):464–471. doi: 10.1017/s1092852900017971. [DOI] [PubMed] [Google Scholar]
  8. Otto M. W., Wilhelm S., Cohen L. S., Harlow B. L. Prevalence of body dysmorphic disorder in a community sample of women. Am J Psychiatry. 2001 Dec;158(12):2061–2063. doi: 10.1176/appi.ajp.158.12.2061. [DOI] [PubMed] [Google Scholar]
  9. Phillips K. A. Body dysmorphic disorder: clinical aspects and treatment strategies. Bull Menninger Clin. 1998 Fall;62(4 Suppl A):A33–A48. [PubMed] [Google Scholar]
  10. Phillips K. A. Body dysmorphic disorder: the distress of imagined ugliness. Am J Psychiatry. 1991 Sep;148(9):1138–1149. doi: 10.1176/ajp.148.9.1138. [DOI] [PubMed] [Google Scholar]
  11. Phillips K. A., Castle D. J. Body dysmorphic disorder in men. BMJ. 2001 Nov 3;323(7320):1015–1016. doi: 10.1136/bmj.323.7320.1015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Phillips K. A., Diaz S. F. Gender differences in body dysmorphic disorder. J Nerv Ment Dis. 1997 Sep;185(9):570–577. doi: 10.1097/00005053-199709000-00006. [DOI] [PubMed] [Google Scholar]
  13. Phillips K. A., Dufresne R. G., Jr, Wilkel C. S., Vittorio C. C. Rate of body dysmorphic disorder in dermatology patients. J Am Acad Dermatol. 2000 Mar;42(3):436–441. doi: 10.1016/s0190-9622(00)90215-9. [DOI] [PubMed] [Google Scholar]
  14. Phillips K. A., Grant J., Siniscalchi J., Albertini R. S. Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder. Psychosomatics. 2001 Nov-Dec;42(6):504–510. doi: 10.1176/appi.psy.42.6.504. [DOI] [PubMed] [Google Scholar]
  15. Phillips K. A., Hollander E., Rasmussen S. A., Aronowitz B. R., DeCaria C., Goodman W. K. A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacol Bull. 1997;33(1):17–22. [PubMed] [Google Scholar]
  16. Phillips K. A., McElroy S. L., Keck P. E., Jr, Hudson J. I., Pope H. G., Jr A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases. Psychopharmacol Bull. 1994;30(2):179–186. [PubMed] [Google Scholar]
  17. Phillips K. A., McElroy S. L., Keck P. E., Jr, Pope H. G., Jr, Hudson J. I. Body dysmorphic disorder: 30 cases of imagined ugliness. Am J Psychiatry. 1993 Feb;150(2):302–308. doi: 10.1176/ajp.150.2.302. [DOI] [PubMed] [Google Scholar]
  18. Phillips K. A. Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis. 2000 Mar;188(3):170–175. doi: 10.1097/00005053-200003000-00007. [DOI] [PubMed] [Google Scholar]
  19. Phillips Katharine A., Albertini Ralph S., Rasmussen Steven A. A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Arch Gen Psychiatry. 2002 Apr;59(4):381–388. doi: 10.1001/archpsyc.59.4.381. [DOI] [PubMed] [Google Scholar]
  20. Phillips Katharine A. Pharmacologic treatment of body dysmorphic disorder: review of the evidence and a recommended treatment approach. CNS Spectr. 2002 Jun;7(6):453-60, 463. doi: 10.1017/s109285290001796x. [DOI] [PubMed] [Google Scholar]
  21. Pope H. G., Jr, Gruber A. J., Choi P., Olivardia R., Phillips K. A. Muscle dysmorphia. An underrecognized form of body dysmorphic disorder. Psychosomatics. 1997 Nov-Dec;38(6):548–557. doi: 10.1016/S0033-3182(97)71400-2. [DOI] [PubMed] [Google Scholar]
  22. Rosen J. C., Reiter J., Orosan P. Cognitive-behavioral body image therapy for body dysmorphic disorder. J Consult Clin Psychol. 1995 Apr;63(2):263–269. doi: 10.1037//0022-006x.63.2.263. [DOI] [PubMed] [Google Scholar]
  23. Sarwer D. B., Wadden T. A., Pertschuk M. J., Whitaker L. A. Body image dissatisfaction and body dysmorphic disorder in 100 cosmetic surgery patients. Plast Reconstr Surg. 1998 May;101(6):1644–1649. doi: 10.1097/00006534-199805000-00035. [DOI] [PubMed] [Google Scholar]
  24. Veale D., Boocock A., Gournay K., Dryden W., Shah F., Willson R., Walburn J. Body dysmorphic disorder. A survey of fifty cases. Br J Psychiatry. 1996 Aug;169(2):196–201. doi: 10.1192/bjp.169.2.196. [DOI] [PubMed] [Google Scholar]
  25. Veale D., De Haro L., Lambrou C. Cosmetic rhinoplasty in body dysmorphic disorder. Br J Plast Surg. 2003 Sep;56(6):546–551. doi: 10.1016/s0007-1226(03)00209-1. [DOI] [PubMed] [Google Scholar]
  26. Veale D., Gournay K., Dryden W., Boocock A., Shah F., Willson R., Walburn J. Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behav Res Ther. 1996 Sep;34(9):717–729. doi: 10.1016/0005-7967(96)00025-3. [DOI] [PubMed] [Google Scholar]
  27. Veale D. Over-valued ideas: a conceptual analysis. Behav Res Ther. 2002 Apr;40(4):383–400. doi: 10.1016/s0005-7967(01)00016-x. [DOI] [PubMed] [Google Scholar]
  28. Veale David M., Lambrou Christina. The importance of aesthetics in body dysmorphic disorder. CNS Spectr. 2002 Jun;7(6):429–431. doi: 10.1017/s1092852900017922. [DOI] [PubMed] [Google Scholar]
  29. Veale David, Ennis Michelle, Lambrou Christina. Possible association of body dysmorphic disorder with an occupation or education in art and design. Am J Psychiatry. 2002 Oct;159(10):1788–1790. doi: 10.1176/appi.ajp.159.10.1788. [DOI] [PubMed] [Google Scholar]
  30. Wilhelm S., Otto M. W., Lohr B., Deckersbach T. Cognitive behavior group therapy for body dysmorphic disorder: a case series. Behav Res Ther. 1999 Jan;37(1):71–75. doi: 10.1016/s0005-7967(98)00109-0. [DOI] [PubMed] [Google Scholar]
  31. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

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