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At least 19 recordsLinked to original sources

PubMed1999

In pursuit of perfection: a primary care physician's guide to body dysmorphic disorder.

Body dysmorphic disorder is an under-recognized chronic problem that is defined as an excessive preoccupation with an imagined or a minor defect of a localized facial feature or body part, resulting in decreased social, academic and occupational functioning. Patients who have body dysmorphic disorder are preoccupied with an ideal body image and view themselves as ugly or misshapen. Comorbid psychiatric disorders may also be present in these patients. Body dysmorphic disorder is distinguished from eating disorders such as anorexia nervosa that encompass a preoccupation with overall body shape and weight. Psychosocial and neurochemical factors, specifically serotonin dysfunction, are postulated etiologies. Treatment approaches include cognitive-behavioral psychotherapy and psychotropic medication. To relieve the symptoms of body dysmorphic disorder, selective serotonin reuptake inhibitors, in higher dosages than those typically recommended for other psychiatric disorders, may be necessary. A trusting relationship between the patient and the family physician may encourage compliance with medical treatment and bridge the transition to psychiatric intervention.

Adolescent↗

PubMed1995

Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects.

Adult↗

PubMedDate not supplied

A comparison of eating disorders and body dysmorphic disorder on body image and psychological adjustment.

Eating and body dysmorphic disorders are two diagnoses with body image disturbance as a central feature. No empirical study of the similarity of these disorders or any controlled study of body dysmorphic disorder were available. The present study compared 45 women with anorexia or bulimia nervosa to 51 men and women with body dysmorphic disorder (BDD) and 50 nonclinical controls. The eating disorder patients were mainly preoccupied with weight and body shape. BDD subjects had more diverse physical complaints and reported more negative self-evaluation and avoidance due to appearance. However, the two groups showed equally severe body image symptoms overall, and were clearly abnormal compared with controls. Both types of patients had negative self-esteem, but eating disorder patients had more widespread psychological symptoms. In conclusion, the disorders are comparable on psychological measures. Explanations of the minor differences and questions for future research on the relation between eating and body dysmorphic disorders are presented.

Adaptation, Psychological↗

PubMed1996

Body dysmorphic disorder.

Body dysmorphic disorder is one of the most difficult conditions to manage but a significant proportion of patients do respond to selective serotonin reuptake inhibitors. This group of drugs has helped to revolutionize the treatment of this common but disabling disorder of perceived body ugliness. The condition may affect up to 1% of the population in the United States. Patients often show obsessional features, and depression is common. Ever present is a risk of suicide in these patients.

Body Image↗

PubMed1997

A review of cognitive behavioral and pharmacological treatment of body dysmorphic disorder.

Body dysmorphic disorder (BDD) first appeared in the diagnostic nomenclature in 1987 with the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised (DSM-III-R) (APA, 1987). Currently in DSM-IV (APA, 1994), the criterion of impairment in functioning was added to the already existing criteria of preoccupation with an imagined defect in appearance not accounted for by another mental disorder. The body parts most often perceived as defective are the nose, hair, and complexion. Behavioral and pharmacological studies consist primarily of case reports. Systematic desensitization, exposure and response prevention, and cognitive therapy are promising approaches that need further investigation. Pharmacological agents noted to be beneficial are the selective serotonin reuptake inhibitors. Controlled studies in this area are also needed.

Body Image↗

PubMed2002

Selective processing of emotional information in body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a syndrome characterized by distress about imagined defects in one's appearance. Though categorized as a somatoform disorder, BDD is marked by many characteristics associated with social phobia (e.g., fear of negative evaluation) and obsessive-compulsive disorder (e.g., intrusive thoughts about one's ugliness, checking). In the present experiment, we tested whether BDD patients exhibit selective processing of threat in the emotional Stroop paradigm as do anxiety-disordered patients. Relative to healthy control participants, BDD patients exhibited greater Stroop interference for positive and negative words, regardless of disorder-relevance, than for neutral words. Further analyses suggested that interference tended to be greatest for positive words related to BDD. These data suggest that BDD patients are vulnerable to distraction by emotional cues in general, and by words related to their current concerns in particular. Results suggest that BDD may indeed be related to anxiety disorders such as social phobia.

Adult↗

PubMed2004

Body dysmorphic disorder.

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.

Body Image↗

PubMed2003

Cosmetic rhinoplasty in body dysmorphic disorder.

Body dysmorphic disorder (BDD) occurs in about 5% of patients seeking cosmetic surgery. Such patients are often dissatisfied with surgery or their symptoms of BDD are the same or worse after surgery. We report on a study that was designed to determine the frequency of BDD in patients requesting cosmetic rhinoplasty in the UK and to compare them with BDD patients in a psychiatric clinic. In the first stage of the study, we used a screening questionnaire for BDD and found that 20.7% of patients requesting rhinoplasty had a possible diagnosis of BDD. However, we believe that we identified a group of patients with sub-clinical or very mild BDD who are satisfied by cosmetic rhinoplasty. In the second stage of the study, we compared (a) patients without BDD who had a good outcome after cosmetic rhinoplasty with (b) BDD patients seen in a psychiatric clinic (who crave cosmetic rhinoplasty but for a variety of reasons do not obtain it). We found that BDD patients seen in a psychiatric clinic who desire cosmetic rhinoplasty are a quite distinct population from those obtaining routine rhinoplasty without symptoms of BDD. BDD patients are significantly younger, more depressed and anxious than this group, and are more preoccupied by their nose and check their nose more frequently. They are more likely to conduct "D.I.Y" surgery and have multiple concerns about their body. They are more likely to be significantly handicapped in their occupation, social life, and in intimate relationships and to avoid social situations because of their nose. They are therefore more likely to believe that dramatic changes would occur in their life after a rhinoplasty. This study provides some clues for surgeons who wish to identify patients with BDD who might have a poor prognosis in cosmetic rhinoplasty. Further research is required in the development of a screening questionnaire or interview for identifying patients with BDD seeking cosmetic surgery.

Adult↗

PubMed2004

Psychosis in body dysmorphic disorder.

Body dysmorphic disorder (BDD) has both psychotic and nonpsychotic variants, which are classified as separate disorders in DSM-IV (delusional disorder and a somatoform disorder). Despite their separate classification, available evidence indicates that BDD's delusional and nondelusional forms have many similarities (although the delusional variant appears more severe), suggesting that they may actually be the same disorder, characterized by a spectrum of insight. And contrary to what might be expected, BDD's delusional form, although classified as a psychotic disorder, appears to respond to serotonin-reuptake inhibitors alone. These and other data suggest that a dimensional view of psychosis (in particular, delusions) in these disorders may be more accurate than DSM's current categorical view. A dimensional model might also facilitate more consistent and accurate classification of other disorders that are likely characterized by a spectrum of insight, such as obsessive compulsive disorder, hypochondriasis, and anorexia nervosa. Further research is needed to better understand these classification issues, which likely have treatment implications.

Adult↗

PubMed2002

Current concepts in body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a potentially debilitating psychiatric illness characterized by intense preoccupation with an imagined or slight defect in physical appearance. Until recently, it has gone largely unrecognized and did not appear in the Diagnostic and Statistical Manual of Mental Disorders until 1987. Improved methods of assessment and treatment of BDD have increased interest in this disorder. This article reviews current literature on BDD, including the similarities between BDD and obsessive-compulsive disorder (OCD), current assessment and treatment strategies, and implications for clinical practice and future research.

Cognitive Behavioral Therapy↗

PubMed2000

Quality of life for patients with body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a relatively common, distressing, and impairing disorder. Quality of life in BDD, however, has not been investigated. In this study, 62 consecutive outpatients with BDD were evaluated with the self-report Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and other scales. SF-36 scores were descriptively compared to published norms for several populations. Physical health-related quality of life scores were generally worse than general U.S. population norms and better than norms for outpatients with a medical illness or depression. However, in all mental health domains, BDD subjects' scores were notably worse than norms for the general U.S. population and for patients with depression, diabetes, or a recent myocardial infarction. More severe BDD symptoms and greater delusionality were associated with poorer mental health-related quality of life. These results indicate that patients with BDD have notably poor mental health status and mental health-related quality of life.

Adolescent↗

PubMed1996

Pharmacologic treatment of body dysmorphic disorder.

Body dysmorphic disorder (BDD), a preoccupation with an imagined or slight defect in appearance, has been described for more than a century and reported around the world. However, investigation into the treatment of this distressing and impairing disorder is just beginning. Available data on the pharmacologic treatment of BDD suggest that it often responds to serotonin reuptake inhibitors (SRIs), which may be preferentially effective for this disorder. Augmentation of SRIs with buspirone and neuroleptics, as well as combinations of SRIs, also appear promising. Available data also suggest that serotonin reuptake inhibitors may be effective for delusional BDD (a type of delusional disorder, somatic type). Because controlled treatment studies are lacking, however, these findings are preliminary. Controlled pharmacotherapy studies, which are under way, are greatly needed.

Adult↗

PubMed1995

Assessment of body image in eating disorders with the body dysmorphic disorder examination.

The Body Dysmorphic Disorder Examination (BDDE) has several advantages for the assessment of body image in eating disorder patients. It measures distressing self-consciousness, preoccupation with appearance, overvalued ideas about the importance of appearance to one's self-worth, and body image avoidance and checking behaviors. The BDDE is relevant for any type of appearance complaint and is not limited to weight or body shape concerns. The BDDE measures the useful targets for body image therapy. In a sample of eating disorder patients, the Body Dysmorphic Disorder Exam had good internal consistency and was significantly correlated with other measures of body image. It added new information to the discrimination of women with eating disorders from clinical and nonclinical controls beyond that provided by other measures of body image.

Adolescent↗

PubMedDate not supplied

Prevalence of body dysmorphic disorder in patients with anxiety disorders.

Body Dysmorphic Disorder (BDD) is a debilitating disorder that often goes undetected in clinical practice. To provide information on the diagnostic correlates of BDD, we examined rates among outpatients seeking treatment for anxiety disorders. Participants (N = 165) were evaluated with a structured clinical interview and received the following primary diagnoses: panic disorder (n = 80), obsessive-compulsive disorder (n = 40), social phobia (n = 25) and generalized anxiety disorder (n = 20). Overall, 6.7% of patients met criteria for BDD. Rates were highest for social phobia (12%). When comorbid social phobia was excluded, rates of BDD were 1.5% in panic disorder, 6.7% in generalized anxiety disorder, and 7.7% in obsessive-compulsive disorder. In all cases, onset of social phobia preceded onset of BDD. Our findings draw attention to the prevalence of BDD in patients with social phobia. The potential etiologic significance of our findings is discussed.

Adult↗

PubMedDate not supplied

Comparison of clinical characteristics in obsessive-compulsive disorder and body dysmorphic disorder.

Recent research has suggested that body dysmorphic disorder (BDD) is part of the spectrum of obsessive-compulsive disorders. In order to determine the extent of similarity for psychopathology measures, patients diagnosed with BDD were compared to a group of patients diagnosed with obsessive-compulsive disorder (OCD) on obsessionality, compulsivity, overvalued ideas, depression, and anxiety. Results indicate that BDD patients are similar to OCD patients for measures of obsessionality and compulsivity when BDD symptoms are assessed as such. BDD and OCD patients were also similar for measures of depression, and state and trait anxiety. OCD patients had higher levels of anxiety when measuring common physical symptoms associated with this affective reaction. BDD patients had higher levels of overvalued ideas, but fewer obsessive and compulsive symptoms. Overall, the results suggest that BDD is a variant of OCD, with special considerations given to degree of belief conviction (overvalued ideas.

Adult↗

PubMedDate not supplied

Insight in obsessive compulsive disorder and body dysmorphic disorder.

Similarities between obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) have been described in terms of clinical presentation, comorbidity rates, treatment response profiles, and other features. This is the first study to compare insight in OCD and BDD measuring global insight and numerous components of insight. We compared insight in 64 adult outpatients with DSM-IV OCD and 85 adult outpatients with DSM-IV BDD using a reliable and valid measure (the Brown Assessment of Beliefs Scale [BABS]). BDD patients had significantly poorer global insight than OCD patients. BDD patients also had significantly poorer insight on the following components of insight: conviction that the belief is accurate, perception of other's views of the belief, explanation for differing views, willingness to consider that the belief is wrong, and recognition that the belief has a psychiatric/psychological cause. Poorer insight was significantly positively correlated with more severe symptoms of the disorder only in the BDD group.

Adult↗

PubMed1997

Gender-related differences in body dysmorphic disorder (dysmorphophobia).

Body Dysmorphic Disorder (BDD), which consists of pathological preoccupations with defects in different body parts, has been systematically studied only in the last decade. We hypothesized that gender would differentially influence the localization of the preoccupations as well as the extent and type of comorbidity with other psychiatric disorders. With the use of a specially constructed semistructured interview, we evaluated 58 consecutive outpatients with DSM-III-R BDD (women = 41.4%, men = 58.6%). Women had significantly more preoccupations with breast and legs, checking in the mirror and camouflaging, as well as lifetime comorbidity with panic, generalized anxiety, and bulimia. Men had significantly higher preoccupations with genitals, height, excessive body hair, as well as higher lifetime comorbidity with bipolar disorder. Although BDD is almost never found without comorbidity, it does appear to be an autonomous syndrome, and gender tends to influence the nature and extent of this comorbidity.

Adolescent↗

PubMed2000

Characteristics of memory dysfunction in body dysmorphic disorder.

Although body dysmorphic disorder (BDD) is receiving increasing empirical attention, very little is known about neuropsychological deficits in this disorder. The current study investigated the nature of memory dysfunction in BDD, including the relationship between encoding strategies and verbal and nonverbal memory performance. We evaluated 17 patients with BDD and 17 healthy controls using the Rey-Osterrieth Complex Figure Test (RCFT) and the California Verbal Learning Test (CVLT). BDD patients differed significantly from healthy controls on verbal and nonverbal learning and memory indices. Multiple regression analyses revealed that group differences in free recall were statistically mediated by deficits in organizational strategies in the BDD cohort. These findings are similar to patterns previously observed in obsessive-compulsive disorder (OCD), suggesting a potential relationship between OCD and BDD. Studies in both groups have shown that verbal and nonverbal memory deficits are affected by impaired strategic processing.

Adult↗