Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Body dysmorphic disorder (BDD) (previously known as Dysmorphophobia[1] and sometimes referred to as Body dysmorphia) (also known as “Dysmorphic syndrome,” and “Dysmorphophobia”[2]) is a psychiatric disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in their physical features. The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs occupational and/or social functioning, sometimes to the point of complete social isolation.[3] It is estimated that between 1%-2% of the world’s population meet all the diagnostic criteria for BDD.
Individuals with very obvious and immediately-noticeable defects should not be diagnosed with BDD, however culture and clinician bias may play a significant part in the subjectivity behind determining what physical appearance is considered ‘normal’ and in whom the disorder is diagnosed.[4] BDD combines obsessive and compulsive aspects, linking it, among psychologists, to the obsessive-compulsive spectrum disorders. The exact cause or causes of BDD is unknown, but most clinicians believe it to be a complex combination of biological, psychological and environmental factors.
Onset of symptoms generally occurs in adolescence or early adulthood, although cases of BDD onset in children and older adults is not unknown. BDD is often misunderstood to affect mostly women, however research shows that it affects men and women equally. The disorder is linked to significantly diminished quality of life and co-morbid major depressive disorder and social phobia. With a completed-suicide rate more than double than that of major depression, and a suicidal ideation rate of around 80%, BDD is considered a major risk factor for suicide. A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) to be effective in treating BDD. BDD is a chronic illness and symptoms are likely to persist, or worsen, if left untreated.
The Diagnostic and Statistical Manual of Mental Disorders defines body dysmorphic disorder as a preoccupation with an imagined or minor defect in appearance which causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The individual’s symptoms mustn’t be better accounted for by another disorder, for example weight concern is usually more accurately attributed to an eating disorder.
The disorder generally is diagnosed in those who are extremely critical of their physique or self-image even though there may be no noticeable disfigurement or defect, or a minor defect which is not recognised by most people. Most people wish that they could change or improve some aspect of their physical appearance; but people suffering from BDD, generally of normal or even highly attractive appearance, 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. They tend to be very secretive and reluctant to seek help because they fear that others will think them vain or because they feel too embarrassed. It has also been suggested that fewer men seek help for the disorder than women.[5]
Ironically, BDD is often misunderstood as a vanity-driven obsession, whereas it is quite the opposite, for people with BDD believe themselves to be irrevocably ugly or defective.
BDD combines obsessive and compulsive aspects, linking it, among psychologists, to the Obsessive-Compulsive spectrum disorders. People with BDD may compulsively look at themselves in the mirror or avoid mirrors, typically think about their appearance for at least one hour a day (and usually more), and in severe cases may drop all social contact and responsibilities as they become a recluse.
A German study has shown that 1–2% of the population meet all the diagnostic criteria of BDD, with a larger percentage showing milder symptoms of the disorder (Psychological Medicine, vol 36, p 877). Chronically low self-esteem is characteristic of those with BDD, because the one’s assessment of one’s value is so closely linked with one’s perception of one’s appearance. BDD is diagnosed equally in men and women, and causes chronic social anxiety for its sufferers.[6]
Phillips & Menard (2006) found the completed-suicide rate in patients with BDD was 45 times higher than in the general United States population. This rate is more than double that of those with clinical depression and three times as high as that of those with bipolar disorder.[7] Suicidal ideation is also found in around 80% of people with BDD.[8] There has also been a suggested link between undiagnosed BDD and a higher than average suicide rate among people who have undergone cosmetic surgery.[9]
[tubepress mode=’tag’, tagValue=’Body dysmorphic disorder’]