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Postgrad Med J 80:67-71 doi:10.1136/pmj.2003.015289
  • Review

Body dysmorphic disorder

  1. D Veale
  1. Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University of London, London, UK
  1. Correspondence to:
 Dr David Veale
 The Priory Hospital North London, The Bourne, Southgate, London N14 6RA, UK; davidveale.co.uk
  • Received 21 September 2003
  • Accepted 22 September 2003

Abstract

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.

Footnotes

  • * An Italian psychiatrist, Morselli, coined the term dysmorphophobia in 1886, but it is used less often nowadays probably because ICD-10 (World Health Organisation 1992 2244/id) has subsumed it under hypochondriacal disorder.