Body dysmorphic disorder Quiz: Ace Your Exams

A 32-year-old woman comes to the physician due to recurrent unpleasant thoughts. The patient tells the physician that whenever she sees a trash can, she thinks that she has lost money in it, and she has to go check through it for her money. She adds that although she knows these thoughts are not logical, she cannot stop thinking about it and always has to go thoroughly check the trash cans, sometimes multiple times over. Over the past year, she has had a few distressing moments in which she was caught looking through the trash cans while visiting her friends’ homes, and she has twice been asked to leave. The patient has had these episodes for several years, and they have become increasingly disruptive. She does not hear voices or see things that are not visualized by others. Past medical history is noncontributory. The patient does not use any recreational drugs or drink alcohol. Which of the following is the most likely diagnosis?