Find information on thousands of medical conditions and prescription drugs.

Body dysmorphic disorder

Body dysmorphic disorder (BDD) is a mental disorder which involves a disturbed body image. The central feature of BDD is that persons who are afflicted with it are excessively dissatisfied with their body because of a perceived physical defect. An example would be a woman who is extremely worried that her nose is too big, although other people don't notice anything unusual about it. more...

Bacterial endocarditis
Bacterial food poisoning
Bacterial meningitis
Bacterial pneumonia
Bangstad syndrome
Bardet-Biedl syndrome
Bardet-Biedl syndrome
Bardet-Biedl syndrome
Bardet-Biedl syndrome
Barrett syndrome
Barth syndrome
Basal cell carcinoma
Batten disease
Becker's muscular dystrophy
Becker's nevus
Behcet syndrome
Behr syndrome
Bell's palsy
Benign congenital hypotonia
Benign essential tremor...
Benign fasciculation...
Benign paroxysmal...
Berdon syndrome
Berger disease
Bicuspid aortic valve
Biliary atresia
Binswanger's disease
Biotinidase deficiency
Bipolar disorder
Birt-Hogg-Dube syndrome
Bloom syndrome
Blue diaper syndrome
Blue rubber bleb nevus
Body dysmorphic disorder
Bourneville's disease
Bowen's disease
Brachydactyly type a1
Bright's disease
Brittle bone disease
Bronchiolotis obliterans...
Bronchopulmonary dysplasia
Brown-Sequard syndrome
Brugada syndrome
Bubonic plague
Budd-Chiari syndrome
Buerger's disease
Bulimia nervosa
Bullous pemphigoid
Burkitt's lymphoma
Cavernous angioma

Diagnostic criteria (DSM-IV-TR)

The DSM-IV-TR, the latest version of the diagnostic manual of the American Psychiatric Association (see also: DSM cautionary statement), lists three (3) necessary criteria for a diagnosis of body dysmorphic disorder:

  1. Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive.
  2. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  3. The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in anorexia nervosa).

BDD and other disorders

Note that, according to the DSM criteria, a BDD diagnosis cannot be made if another disorder accounts for the preoccupation with a perceived defect. For instance, people who worry excessively about their weight are not considered to have BDD if this preoccupation is accounted for by an eating disorder. Body dysmorphic disorder is also considered to be different from gender identity disorder and transsexualism, even though the desire to modify one's body is also reflected in people who are judged to have these disorders. Some paraphilias also involve a wish to modify one's body. For example, people with apotemnophilia are convinced that a part of their body needs to be amputated.

In the medical community, some make links between BDD and obsessive-compulsive disorder because there are some similarities between these disorders. For instance, obsessive thoughts and compulsive behaviors are common symptoms of both disorders.


[List your site here Free!]

Treatment of Patients with Body Dysmorphic Disorder
From American Family Physician, 3/15/00 by Jeffrey T. Kirchner

Body dysmorphic disorder (BDD) was first recognized as a distinct condition in 1987 by the American Psychiatric Association. This disorder's primary feature is preoccupation with an imagined or slight defect in one's physical appearance. This preoccupation may result in severe distress, impairment in social and occupational functioning, psychiatric hospitalization, suicidal ideation and suicide attempts. Patients with BDD may perform repetitive and compulsive behaviors in an attempt to mask, examine or change their physical appearance. These may include frequent mirror checking, excessive grooming and skin picking. While most persons are concerned with facial flaws, the focus can also be on other body parts. Up to 50 percent of BDD patients undergo surgical procedures to correct perceived defects. The true incidence of BDD is unknown, but it has been diagnosed in 1.9 percent of nonclinical patients and in 12 percent of psychiatric outpatients.

BDD has been considered an obsessive-compulsive disorder because some of the clinical features are similar (age of onset, intrusive thoughts and recurring behaviors); thus, the treatment of patients with BDD has involved the use of similar medications. Some preliminary study results suggest a limited response to selective serotonin reuptake inhibitors, but no controlled treatment studies have been published. Other agents, such as lithium, neuroleptics, trazadone and benzodiazepines, have not proved effective. Hollander and colleagues performed the first systematic double-blind, controlled study of the pharmacologic treatment of patients with BDD. They compared clomipramine (a potent serotonin reuptake inhibitor) with the active control desipramine (a selective norepinephrine uptake inhibitor).

Patients enrolled were between the ages of 18 and 65 who met the Diagnostic and Statistical Manual of Mental Disorders, 3d ed. rev. (DSM-III-R) criteria for BDD and suffered acute clinical distress or functional impairment as a result. Excluded were patients with DSM-III-R psychiatric disorders (e.g., bipolar disorder, major depression, psychosis). In addition, patients could not have taken other psychiatric medications before the onset of the study (for six weeks if taking fluoxetine, monoamine oxidase inhibitors or investigational drugs, and for two weeks if taking other psychiatric medications). After a placebo run-in period, patients were randomized to take clomipramine or desipramine for eight weeks. At the end of week 8, they were crossed over to the alternative medication for an additional eight weeks of therapy. Dosages were titrated for both medications by a treating psychiatrist at weekly follow-up visits. At each follow-up visit, the patients underwent a variety of assessments that included the BDD modification of the Yale-Brown Obsessive Compulsive Scale, the Clinical Global Impression Scale, the National Institute of Mental Health BDD Scale, the Schneier Disability Profile, the Fixity of Beliefs Questionnaire and the Hamilton Depression Rating Scale.

Of the 40 patients enrolled in the trial, 29 entered active treatment and were randomized. The average age was 34 years, with an almost equal number of men and women. The study revealed that clomipramine was superior to desipramine in decreasing BDD symptoms as measured by three different rating scales. This improvement included patient preoccupation with perceived body defects, symptom severity and repetitive behaviors. Also noted were lower scores on the Hamilton Depression Rating Scale in the patients taking clomipramine. Lastly, clomipramine was significantly more effective than desipramine in improving functional disability. This finding is notable because of the high level of functional disability associated with BDD patients.

The authors conclude that clomipramine is superior to desipramine in treating patients with BDD. They suggest additional studies to evaluate clomipramine versus placebo, further dosing adjustments and a longer term trial.

On-Line Herbal Resources

American Botanical Council

U.S. Food and Drug Administration

Phytochemical database by James A. Duke

Herb Research Foundation

University of Washington Medicinal Herbal Garden

National Institute of Health Office of Alternative Medicine

Adapted with permission from Mar C, Bent S. An evidence-based review of the 10 most commonly used herbs. WJM 1999;171:168-71.


Hollander E, et al. Clomipramine vs desipramine crossover trial in body dysmorphic disorder. Selective efficacy of a serotonin reuptake inhibitor in imagined ugliness. Arch Gen Psychiatry November 1999;56:1033-9.

COPYRIGHT 2000 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group

Return to Body dysmorphic disorder
Home Contact Resources Exchange Links ebay