Body Dysmorphic Disorder

Body-dysmorphic-disorder

Body dysmorphic disorder (BDD) is defined by the DSM-IV-TR as a condition marked by excessive preoccupation with an imaginary or minor defect in a facial feature or localized part of the body.

• Body dysmorphic disorder (BDD) is defined by the DSM-IV-TR as a condition marked by excessive preoccupation with an imaginary or minor defect in a facial feature or localized part of the body.

• The diagnostic criteria specify that the condition must be sufficiently severe to cause a decline in the patient’s social, occupational, or educational functioning. The most common cause of this decline is the time lost in obsessing about the “defect.”

• The DSM-IV-TR assigns BDD to the larger category of somatoform disorders, which are disorders characterized by physical complaints that appear to be medical in origin but that cannot be explained in terms of a physical disease, the results of substance abuse, or by another mental disorder.

• The central symptom of BDD is excessive concern with a specific facial feature or body part. Research done in the United Kingdom and the United States indicates that the features most likely to be the focus of the patient’s attention are (in order of frequency) complexion flaws (acne, blemishes, scars, wrinkles); hair (on the head or the body, too much or too little); and facial features (size, shape, or lack of symmetry). The patient’s concerns may, however, involve other body parts, and may shift over time from one feature to another.

• Other symptoms of body dysmorphic disorder include:
• Frequent requests for reassurance from others about their appearance.
• Frequently comparing one’s appearance to others.
• Avoiding activities outside the home, including school and social events.
• Ritualistic behavior. Ritualistic behavior refers to actions that the patient performs to manage anxiety and that take up excessive amounts of his or her time. In the context of BDD, ritualistic behaviors may include exercise or makeup routines, assuming specific poses or postures in front of a mirror, etc.

• Camouflaging the “problem” feature or body part with makeup, hats, or clothing.
• Abnormal behavior around mirrors, car bumpers, large windows, or similar reflecting surfaces. A majority of patients diagnosed with BDD frequently check their appearance in mirrors or spend long periods of time doing so.

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