Body Dysmorphic Disorder
Original Editors - Sean Beard & Jimmy Crick from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Sean Beard, James Crick, Rucha Gadgil, Kalyani Yajnanarayan, Elaine Lonnemann, Kim Jackson, 127.0.0.1, Wendy Walker, WikiSysop and Amanda Ager
Definition/Description[edit | edit source]
Body dysmorphic disorder (BDD) , is a disorder characterized by extreme preoccupation with appearance, that also causes personal distress in the presence of minimal or no defects. BDD is commonly considered to be an obsessive-compulsive spectrum disorder, based on extreme similarities it has with obsessive-compulsive disorder. Often BDD is presented to dermatologists and plastic surgeons without referral to a psychiatrist. Currently this disorder is classified as a somatoform disorder, but may also fall under the heading of an anxiety disorder. [1][2][3]
A patient that may have this disorder is concerned with a specific body part, which may help differentiate them from a patient who may suffer from an eating disorder. [4]
First described as dysmorphophobia, in 1886 in European medical literature, and later numerously described under several names, such as; dermatologic hypochondriasis, beauty hypochondria, dermatologic nondisease, primary monosymptomatic hypochondriacal psychosis. [3]
Prevalence[edit | edit source]
BDD effects approximately 0.7% to 2.4% of general population. Specifically, in the United States, 2.2% of men and 2.5% of women suffer from BDD. [6] Typically patients present in adolescence with an average age of sixteen years. Increased prevelance of BDD is seen in dermatological and cosmetic surgery practices.[3]
In spite of early onset of disease, most afflicted persons defer seeking treatment until early thirties. BDD seems to effect men and women equally, however some studies report a slightly higher frequency in women.[1]
Characteristics/Clinical Presentation [1][2][3][4][7][edit | edit source]
Most common bodily areas of preoccupation include:
- skin: scarring, color, acne, wrinkles
- hair: going bald, excessive facial or body hair
- facial features: nose, eyelids
- breast: size, shape
- muscle: "muscle dysmorphia"
- body height/weight
- penis: "Koro" is a traditional Chinese misconception that the penis is shrinking[3]
- thighs
- buttocks
- body odor
People that suffer from BDD have a preoccupation with 5-7 distinct body parts.[8] Men most commonly ascribe defects to their height, hair, body proportion, and genitals. Women are more likely to report concerns with their hips, thighs, buttocks, legs, breast, and body weight. Obvious outward habits with people with BDD include compulsive behaviors such as:
- constant seeking or avoidance of reflection in windows, mirrors, spoons
- excessive grooming, or attempts to camouflage dress
- overuse of diet and exercise
- nervous tendancy to pick at skin imperfections
- comparing oneself to others
- repeated measuring or touching of perceived defect
In extreme cases of BDD, people may resort to:
- self-mutilation
- social isolation
- substance abuse
- seeking surgical intervention through self or professionally
Social manifestations of BDD may include:
- overreliance on positive feedback from partner, parent, spouse, friend, etc.
- decreased work and/or school performance and/or attendance.
- maintaining interpersonal relationships becomes strained or impossible.
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References[edit | edit source]
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- ↑ 1.0 1.1 1.2 Crerand CE, Franklin ME, Sarwer DB. Body dysmorphic disorder and cosmetic surgery. Plast Reconstr Surg. 2006;118(7):167e-80e.
- ↑ 2.0 2.1 Bjornsson AS, Didie ER, Phillips KA. Body dysmorphic disorder. Dialogues Clin Neurosci. 2010;12(2):221-32.
- ↑ 3.0 3.1 3.2 3.3 3.4 Gupta R, Huynh M, Ginsburg IH. Body dysmorphic disorder. Semin Cutan Med Surg. 2013;32(2):78-82.
- ↑ 4.0 4.1 WebMD: Mental Health Center. Body Dysmorphic Disorder. http://www.webmd.com/mental-health/mental-health-body-dysmorphic-disorder (accessed 3 March 2014).
- ↑ Onlymyhealth. Understanding Body Dysmorphic Disorder. http://www.google.com/imgres?imgurl=&imgrefurl=http%3A%2F%2Fwww.onlymyhealth.com%2Funderstanding-body-dysmorphic-disorder-1285581494&h=0&w=0&sz=1&tbnid=LZ67Cr1MthucwM&tbnh=240&tbnw=160&zoom=1&docid=3ZhrRNCJI4ZE0M&ei=rJwUU-HHO-GfyQG-8IDQDw&ved=0CAUQsCUoAQ (Accessed 3 March 2014).
- ↑ Koran LM, Abujaoude E, Large MD, Serpe RT. The prevalence of bodyfckLRdysmorphic disorder in the United States adult population. CNS Spectr.fckLR2008;13(4):316-322.
- ↑ Ross J, Gowers S. Body dysmorphic disorder. Advances in Psychiatric Treatment. 17(2):142-149.
- ↑ Phillips, K. A., Menard, W., Fay, C., et al. Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics 46: 317, 2005.
