Body dysmorphic disorder
|Body Dysmorphic Disorder|
|Classification and external resources|
Body dysmorphic disorder (BDD, also known as body dysmorphia, dysmorphic syndrome; originally dysmorphophobia) is a chronic mental illness, a somatoform disorder, wherein the afflicted individual is concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of their physical appearance. An individual with BDD has perpetual negative thoughts about their appearance; in the majority of cases, an individual suffering from BDD is obsessed with a minor or imagined flaw. Afflicted individuals think they have a defect in either one or several features of their body, which causes psychological and clinically significant distress or impairs occupational or social functioning. BDD often co-occurs with depression, anxiety, social withdrawal, and social isolation.
The causes of body dysmorphic disorder vary for each person, but are usually a combination of biological, psychological, and environmental factors. It may occur in children and adults. The symptoms of body dysmorphia include depression, social phobia, and obsessive compulsive disorder.
BDD is linked to a diminished quality of life, can be co-morbid with major depressive disorder and social phobia (chronic social anxiety) and is associated with suicidal ideation. BDD can be treated with either psychotherapy or psychiatric medication. Although originally a mental-illness diagnosis usually applied to women, body dysmorphic disorder also occurs in men. Approximately one percent of adults meet the diagnostic criteria for body dysmorphic disorder.
|This article is outdated. (November 2013)|
The Diagnostic and Statistical Manual of Mental Disorders defines body dysmorphic disorder as a somatoform disorder marked by a preoccupation with an imagined or trivial defect in appearance that causes clinically significant distress or impairment in social, occupational or other important areas of functioning. The individual's symptoms must not be better accounted for by another disorder; for example, weight concern in the case of anorexia nervosa.
Signs and symptoms
People with BDD say that they wish that they could change or improve some aspect of their physical appearance even though they may generally be of normal or even highly attractive appearance. Body dysmorphic disorder may cause sufferers to believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance. This can cause those with this disorder to begin to seclude themselves or have trouble in social situations. More extreme cases may cause a person to develop love-shyness, a chronic avoidance of all intimate relationships. They can become secretive and reluctant to seek help because they fear that seeking help will force them to confront their insecurity. They may feel too embarrassed and unwilling to accept that others will tell the sufferer that they are suffering from a disorder. The sufferer believes that fixing the "deformity" is the only goal, and that if there is a disorder, it was caused by the deformity. In extreme cases, patients report that they would rather suffer from their symptoms than be 'convinced' into believing that they have no deformity.
|This article is outdated. (November 2013)|
BDD is under-diagnosed due to the disorder only recently being included in DSM IV; therefore, clinician knowledge of the disorder, particularly among general practitioners, is not widespread. BDD is often associated with shame and secrecy so individuals may not reveal their appearance concerns for fear of appearing vain or superficial.
BDD is also often misdiagnosed because its symptoms can mimic that of major depressive disorder or social phobia.
Cognitive behavior therapy (CBT) has not been well studied in BDD; a secondary review concluded that "Current studies do not allow us to ascertain the real effect of each cognitive and behavioral intervention, what specific conditions of cognitive behavioral-based therapies may optimize pharmacological treatment, and which patients are most likely to benefit from CBT."
Individuals with BDD seek treatment from dermatologists or cosmetic surgeons with little satisfaction before finally accepting psychiatric or psychological help. BDD is associated with suicidal ideation and can lead to alcoholism or illicit drug use.
The disorder was first documented in 1891 by Enrique Morselli, who dubbed the condition dysmorphophobia. BDD was recognized by the American Psychiatric Association as a disorder in 1987 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. It has since been changed from dysmorphophobia to body dysmorphic disorder because the original implies a phobia of people, not a reluctance to interact socially because of poor body image.
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- Phillips, Katharine A. (1996). The Broken Mirror. Oxford University Press. p. 47.
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- TV documentary by former BDD sufferer John Furse