Body dysmorphic disorder. Epidemiology, clinical symptoms, classification and differential treatment indications: an overview

Body dysmorphic disorder (BDD), also known as dysmorphophobia, is a relatively common disorder that consists of preoccupation with some imagined or slight defect in physical appearance. The preoccupation causes emotional distress and social impairment. Overvalued I ideation and referential thinking are prevalent. BDD has a rich tradition in European psychiatry, but it first entered the official psychiatric nomenclature as a separate disorder in DSM-III-R in 1987. In the last 10 years it has received increasing empirical attention. BDD has been hypothesized to be related to obsessive-compulsive disorder (OCD) or may be conceptualized as hypochondriacal disorder. According to its body image disturbance it has been related to cenesthesia, eating disorders, and transsexualism. This paper presents the current level of awareness about BDD based on an analysis of the relevant literature. Empirical data are summarized and clinical signs are described. Varying therapies are critically reviewed.