Body Dysmorphic Disorder: Characteristics, Psychopathology, Clinical Associations, and Influencing Factors

Abstract

Body dysmorphic disorder (BDD) is defined by a recurring and persistent concern characterized by psychic suffering caused by a possible physical imperfection in appearance. It is a severe psychiatric condition, duly confirmed by neuroanatomical findings, very peculiar repetitive behaviors, and specific personalities. The prevalence of BDD is increasing around the world and differs between countries, because of cultural differences and different health-care systems. This increase is worrying because BDD is a pathology that presents comorbidity like severe depression, suicidal ideation, and functional and social impairment. However, BDD is an unrecognized and often not diagnosed in our society. Many patients are ashamed of their complaints and do not usually seek psychiatric help with ease, and unfortunately, they seek help in cosmetic and surgical treatments to improve their appearance, and these professionals are not yet prepared to assist in the diagnosis of this disorder. Therefore, this chapter presents not only the psychopathology of BDD but also its associations with other pathologies and their main factors of influence. Finally, we present a clinical experience with a detailed description of a clinical case. The aim is to contribute to the diagnosis and treatment of this pathology and also to future research that may benefit society and these patients.

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“…BDD has been associated with other clinical conditions, including obsessive–compulsive disorder, eating disorders, and addictive behaviors ( 56 , 57 ). BDD causes considerable distress and interferes significantly with physical and social functioning ( 41 , 58 , 59 ). Yet, it is an under-recognized and underdiagnosed condition ( 59 ), namely, because people suffering from it rarely seek intervention for the condition itself, rather for the perceived flaws or for the related mental disorders (e.g., addictive behaviors).…”

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“…BDD is under recognized and often not diagnosed [42]. The negative impact of untreated BDD to the patient extends to most aspects of a person’s life and ultimately their mental health, as evidenced by the frequent associations with severe depression, suicidal ideation as well as both functional and social impairment [44, 45].…”