Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) was not recognized as a unique diagnosis until 1987. Since that time, there has been a marked increase in systematic research into the characterization, comorbidities, and treatment of BDD. The essential feature of BDD is preoccupation with an imagined defect in appearance in a normal-appearing person or a markedly excessive concern about a slight imperfection (Allen and Hollander, 2000). The preoccupation must cause significant distress or impairment in functioning and must not be confined to another disorder, for example, preoccupation with obesity in anorexia nervosa. BDD is relatively common and has been reported to affect 1.9 percent of nonclinical samples (Rich et al., 1992) and 12 percent of psychiatric outpatients (Zimmerman et al., 1998). Similar to OCD, serotonin reuptake inhibitors

(SRIs) (such as clomipramine, fluoxetine, and fluvoxamine) demonstrate specific efficacy in the treatment of BDD (Hollander et al., 1989; Phillips et al., 1998). Although only a few controlled studies on psychotherapy for patients with BDD have been done, cognitive-behavioral therapy has been found to be effective (Grant and Cash, 1995; Neziroglu et al., 1996).

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