Body Dysmorphic Disorder (BDD) - Update
New York, NY (February 20, 2001):
Body Dysmorphic Disorder (BDD) is a rare psychiatric disorder characterized by an uncontrollable preoccupation with an imagined or slight defect in appearance. Any body area can be the focus, but most persons with BDD have concerns about more than one area.
BDD was written about as early as 1891, at which time it was called dysmorphophobia. Early conceptualizations do not differ greatly from modern concepts of the disorder. BDD is increasingly classified as an obsessive-compulsive spectrum disorder, but there is still some degree of debate as to exactly what it is.
Individuals with BDD spend a mean time of 3-8 hours a day thinking about perceived physical flaws. They exhibit compulsive repetitive behavior such as camouflaging (wearing hats, multiple layers of clothing, or excessive amounts of make-up); checking their appearance in the mirror; questioning others about their appearance, and constantly seeking reassurance. Low self-esteem, shame and fear of rejection are common, and data suggests that more than half of those with BDD also suffer from major depression. Minor to severe bodily harm is self-inflicted in many instances.
Patients diagnosed as suffering from BDD generally are inappropriate candidates for plastic surgery. It appears most patients with BDD are dissatisfied with the surgical result, regardless of any objective improvement in their appearance. Distress about their appearance may actually increase, or they may become preoccupied with another part of their body.
Those with BDD should speak to their primary doctor or a psychiatrist for treatment options. Success has been reported with cognitive behavior therapy and medications such as Prozac, Paxil and Zoloft. However, controlled clinical studies are necessary to more clearly define the best treatment approaches.
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