Body Dysmorphic Disorder

About Body Dysmorphic Disorder

Body dysmorphic disorder is characterized by preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others. Common concerns involve the skin, such as acne, scars or wrinkles, the hair, the nose, eyes, teeth and other features, and a form called muscle dysmorphia involves the belief that the body is too small or insufficiently muscular. At some point the person performs repetitive behaviors, such as mirror checking, excessive grooming, skin picking, comparing appearance with others or seeking reassurance, or mental acts in response to the concern. Onset is usually in adolescence. DSM-5 places it in the obsessive compulsive and related disorders group and specifies the degree of insight, which can range from good to absent with delusional beliefs. It frequently co occurs with depression, social anxiety and OCD, and rates of suicidal thoughts and attempts are high, making it a serious condition. Many people seek cosmetic or dermatological treatments, which rarely relieve the preoccupation and may worsen it. The Italian psychiatrist Enrico Morselli described the condition in 1891, calling it dysmorphophobia. Cognitive behavioral therapy tailored to the disorder, including exposure and response prevention and perceptual retraining, has the strongest evidence, and SSRIs are among the medications used.