Delusional versus nondelusional body dysmorphic disorder

Mancuso, Serafino G.; Knoesen, Natalie P.; Castle, David

doi:10.1016/j.comppsych.2009.05.001

Cited by 65 publications

(62 citation statements)

References 30 publications

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“…It is associated with high lifetime rates of psychiatric hospitalization (48%) (Phillips and Diaz, 1997a) and suicide attempts (22.2-27.5%) (Buhlmann et al, 2010;Phillips et al, 2005). Insight in BDD is on a continuum, with 35.6-60% of BDD patients being delusional in their convictions of disfigurement (Mancuso et al, 2010;Phillips et al, 2006). Despite its high prevalence and severity, relatively little is known about the neurobiology.…”

Section: Introductionmentioning

confidence: 99%

Abnormal Brain Network Organization in Body Dysmorphic Disorder

Arienzo

Leow

Brown

et al. 2013

Neuropsychopharmacol

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Body dysmorphic disorder (BDD) is characterized by preoccupation with misperceived defects of appearance, causing significant distress and disability. Previous studies suggest abnormalities in information processing characterized by greater local relative to global processing. The purpose of this study was to probe whole-brain and regional white matter network organization in BDD, and to relate this to specific metrics of symptomatology. We acquired diffusion-weighted 34-direction MR images from 14 unmedicated participants with DSM-IV BDD and 16 healthy controls, from which we conducted whole-brain deterministic diffusion tensor imaging tractography. We then constructed white matter structural connectivity matrices to derive whole-brain and regional graph theory metrics, which we compared between groups. Within the BDD group, we additionally correlated these metrics with scores on psychometric measures of BDD symptom severity as well as poor insight/delusionality. The BDD group showed higher whole-brain mean clustering coefficient than controls. Global efficiency negatively correlated with BDD symptom severity. The BDD group demonstrated greater edge betweenness centrality for connections between the anterior temporal lobe and the occipital cortex, and between bilateral occipital poles. This represents the first brain network analysis in BDD. Results suggest disturbances in whole brain structural topological organization in BDD, in addition to correlations between clinical symptoms and network organization. There is also evidence of abnormal connectivity between regions involved in lower-order visual processing and higher-order visual and emotional processing, as well as interhemispheric visual information transfer. These findings may relate to disturbances in information processing found in previous studies.

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Section: Introductionmentioning

confidence: 99%

Abnormal Brain Network Organization in Body Dysmorphic Disorder

Arienzo

Leow

Brown

et al. 2013

Neuropsychopharmacol

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“…These thoughts, impulses, or images ("obsessions") are frequently perceived as intrusive or distressing, and thus the person engages in overt or covert ritualistic behavior ("compulsions") to prevent or neutralize this distress (APA, 2000). Common obsessions include fears of contamination (i.e., exposure to "dirty" or "contaminated" items will result in harm or getting ill) or doing something deemed taboo by society or religion (i.e., thoughts will lead to them engaging in inappropriate sexual behavior, blasphemy, or aggressive acts); needing to have symmetry or exact positioning (i.e., the sensation that something must be "just right," "even," or "balanced"); fixations on certain patterns or response prevention, developmentally appropriate cognitive restructuring, and between-session homework (Brauer et al, 2011;Lewin et al, 2005;Mancuso et al, 2010;Piacentini, Langley, & Roblek, 2007). However, multiple developmentally appropriate adaptations were made to accommodate the special needs of preschool-age children (Freeman et al, 2008).…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 98%

Family-Based Cognitive-Behavioral Treatment for a Preschooler With Obsessive-Compulsive Disorder

Labouliere

Arnold

Storch

et al. 2013

Clinical Case Studies

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Cognitive-behavioral therapy (CBT) with exposure and response prevention is known to be effective in the treatment of older youth (8-17) and adults with obsessive-compulsive disorder (OCD); however, very little is known about the effectiveness of these procedures during early childhood. As such, this case describes the application of a modularized family-based CBT approach focusing on exposure, differential reinforcement of other behaviors (DRO), and reductions in family accommodation with a preschool boy with a primary diagnosis of OCD. Following 12 consecutive family sessions over 6 weeks, "Charley," a 4-year-old Caucasian male, showed substantial reductions in OCD symptomatology. Charley's parents also reported improvements in oppositionality, peer functioning with siblings and at preschool, and in the parent-child relationship. All improvements were maintained at 3-month follow-up. These results provide preliminary support that CBT incorporating exposure, DRO, behavioral parent training, and reductions in family accommodation may be effective for preschoolers with OCD.

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“…ima sumanuta verovanja, za razliku od 2% kod obolelih od opsesivno-kompulzivnog poremećaja [9], [10], [11]. Što manje veruju da su njihovi simptomi iracionalni, manje su motivisani za tretman.…”

Section: Specifikovatiunclassified

Aestetic surgery in the treatment of body dysmorphic disorder: Paradox of bioetics

Batinić¹,

Duišin²,

Barišić³

2014

Engrami

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1 Klinika za psihijatriju, Klinički centar Srbije, Beograd 2 Filozofski fakultet, Univerzitet u Beogradu, Odeljenje za psihologiju Napomena: Rad je saopšten na simpozijum Klinike za psihijatriju Kliničkog Centra Srbije "Bioetika i psihijatrija" održanom u Beogradu od 9-10 oktobra, 2014. Kratak sadržajTelesni dismorfički poremećaj pripada opsesivno-kompulzivnom spektru poremećaja i karakteriše se opsesivnom preokupacijom minornim ili nepostojećim manama u fizič-kom izgledu koje nisu vidljive ili su beznačajne za druge ljude, uz repetitivna ponaša-nja kao što su konstantno ogledanje, preterano doterivanje, kamuflaža, traženje razuveravanja, itd. Koža, kosa i nos su najčešća područja opsesivnih preokupacija. Uzrokuje značajnu patnju i oštećenje funkcionisanja. Stope suicidalne ideacije iznose i do 80%, a pokušaji sucida u toku života od 24%-48%. Istraživanja ukazuju da 27%-39% ovih pacijenata nema uvid u poremećaj. Pogadja 0.7%-2.4% opšte populaćije, a učestalost u ordinacijama plastične hirurgije iznosi 6.3%-9%. Želja za estetskom hirurgijom u ovom slučaju je deo problema: pogrešnog verovanja da je "greška" u telu. Estetska hirurgija u nekim slučajevima može da donese privremeno olakšanje, kao svojevrsan kompulzivni akt, ali dugotrajna praćenja ukazuju da održava ili pogoršava telesni dismorfički poremećaj, jer se u setingu "nelimitiranog narcizma" najčešće egzarcerbira preokupacija telesnim nedostacima. Zbog toga što se radi o poremećaju slike tela i opsesiji zamišljenim a ne realnim defektom, povećavaju se zahtevi za ponovljenim intervencijama da bi se postiglo "idealno rešenje", čime mnogi od ovih pacijenata postaju "adikti plastične hirurgije" i u krajnjem ishodu žrtve "viška operativnih intervencija". Tako su hiruške intervencije kod osoba sa telesnim dismorfičkom poremećajem kristalizacija paradoksa vezanih za estetsku hirurgiju kao način lečenja "kompleksa inferiornosti" i "uravnoteženja psihe".Uz prikaz slučaja iz naše kliničke prakse, diskutovani su etički paradoksi hiruških intervencija kod osoba sa telesnim dismorfičkim poremećajem vezani za hirurgiju "po želji", poštovanje prava autonomije, principi dobrobiti pacijenta i nenanošenja štete, informisani pristanak, itd. Ukazano je na načine i neophodnost identifikacije osoba sa telesnim dismorfičkim poremećajem u ordinacijama estetskih hirurga i njihovo upućivanje na psihijatrijski tretman. Sa velikom moći izmene telesnog izgleda u modernom društvu, treba da raste i odgovornost plastičnih hirurga i etičko preispitivanje profesionalnog ponašanja.Ključne reči: telesni dismorfički poremećaj, estetska hirurgija, paradoks, bioetika

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Delusional versus nondelusional body dysmorphic disorder

Cited by 65 publications

References 30 publications

Abnormal Brain Network Organization in Body Dysmorphic Disorder

Abnormal Brain Network Organization in Body Dysmorphic Disorder

Family-Based Cognitive-Behavioral Treatment for a Preschooler With Obsessive-Compulsive Disorder

Aestetic surgery in the treatment of body dysmorphic disorder: Paradox of bioetics

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