Recognizing body dysmorphic disorder (dysmorphophobia)

Abstract

Dysmorphophobia is a psychiatric condition which frequently presents in the clinics of dermatologists and plastic surgeons. This disorder (also called body dysmorphic disorder) is troublesome to the patient whilst being confusing for the doctor. This commonly undiagnosed condition can be detected by a few simple steps. Timely referral to a psychiatrist benefits most patients suffering from it. This article describes with a case vignette, how to recognize body dysmorphic disorder presenting in the dermatological or aesthetic surgery set up. Diagnostic criteria, eitiology, approach to patient, management strategy and when to refer are important learning points. The importance of recognizing this disorder timely and referring the patient to the psychiatrist for appropriate treatment is crucial. This article covers all aspects of body dysmorphic disorder relevant to dermatologists and plastic surgeons and hopes to be useful in a better understanding of this disorder.

Etiological factors and treatment challenges in an adolescent male with body dysmorphic disorder: A case report

“…While the effect of such cosmetic procedures clearly undermines the use of medication and psychotherapeutic interventions, discontinuation may not be the best option either considering the nature of the illness and established evidence that such cosmetic procedures may allay the level of preoccupation temporarily, but this is likely to resurface or may take the form of new preoccupations related to other parts of the body. 11 The association between BDD and serotonergic activity supports continued use of Selective Serotonin Reuptake Inhibitors (SSRI) (fluoxetine in our case) irrespective of any cosmetic procedures that the young person may undergo in future. We know that there is decreased serotonin transporter binding density in obsessive-compulsive disorder (OCD)-related disorders, including BDD.…”

An update on psychopharmacological treatment of Body Dysmorphic Disorder (BDD)

“…A serious concern is that individuals with BDD often suffer an increased risk of suicide with rates of suicidal ideation ranging from 17%-77%, and suicide attempts from 3%-63%. [4][5][6] The bodily areas in target of the preoccupations are the skin, hair, nose, eyes, eyelids, mouth, lips, jaw, and chin, although it may involve any part of the body, or multiple body parts at the same time. With regard to the obsessive thinking, this typically includes perceived or slight defects or flaws on the face, asymmetrical or disproportionate face or body features, including wrinkles, scars, thinning of hair, acne, vascular markings, and pallor, or ruddiness of skin texture.…”

Individual Psychological Characteristics of Patients With Body Dysmorphic Disorder Seeking Cosmetic Rhinoplasty

“…Most people with BDD do not realize that their defect is minimal or absent. They misjudge the psychiatric origin of their problems and often desire aesthetic treatment to solve their appearance problems, that is, they seek cosmetics for the treatment of a mental disorder [2][3][4][5].…”

“…Thus, aesthetic rhinoplasty is considered one of the most frequently requested and performed surgical procedures in this population. However, there is growing agreement that BDD should be considered a contraindication for aesthetic rhinoplasty as there is no favorable outcome [4][5][6][7][8][9][10][11][12]. Therefore, given the ethical, safe and legal considerations associated with aesthetic procedures in these patients, accurate identification and appropriate selection of procedures are crucial.…”