Diagnosis of Body Dysmorphic Disorder

Abstract

Body dysmorphic disorder (BDD) is a chronic and severe disorder that needs to be recognized amongst dermatologists, plastic surgeons, and those who provide aesthetic medicine and care. Patients with BDD have a preoccupation with an imagined or slight physical defect that causes clinically appreciable impairment in social, occupational, and/or other functioning. In addition, they exhibit repetitive behaviors or mental acts. In a small study of 59 dermatologists, 63% were comfortable making a diagnosis of body dysmorphic disorder, and only 15% of those queried believed that they could successively treat the disorder. The correct diagnosis can be a challenge, as it may overlap or have similarities with other psychological conditions, such as depression, anxiety, eating disorders, social anxiety, and obsessive-compulsive disorders. In addition, for those with slight abnormalities and mild disease symptoms, it may be very difficult to decide if the preoccupation is considered disproportionate. The new DSM-V now includes BDD under the section of obsessive-compulsive-related disorders, reflecting the increasing body of evidence that these disorders are somehow linked. In addition, the delusional variant of BDD is no longer coded as both delusional disorder and BDD. Rather, it is now diagnosed with a specifier indicating degree of insight. Although there is no single diagnostic tool that has been universally accepted, many self-report questionnaires and rating scales exist and can be used in clinical or research settings to identify and measure BDD symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved)