Body dysmorphic disorder

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Summary of Body dysmorphic disorder

Body dysmorphic disorder is a mental disorder characterized by an obsessive preoccupation that some aspect of one's own appearance is severely flawed and warrants exceptional measures to hide or fix it. In BDD's delusional variant, the flaw is imagined. If the flaw is actual, its importance is severely exaggerated. Either way, one's thoughts about it are pervasive and intrusive, occupying up to several hours a day. The DSM-5 categorizes BDD in the obsessive–compulsive spectrum, and distinguishes it from anorexia nervosa.

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Body dysmorphic disorder

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BODY DYSMORPHIC DISORDER osms.it/BDD PATHOLOGY & CAUSES DIAGNOSIS ▪ Characterized by an obsessive belief that one’s appearance is ﬂawed ▪ Can cause compulsive behaviors (e.g. excessive grooming) ▪ Not caused by other condition/substance CAUSES ▪ No consensus on optimal treatment ▪ Genetic, environmental; linked to issues with serotonin neurotransmitters SIGNS & SYMPTOMS ▪ Obsessive belief that one’s appearance is ﬂawed ▪ Compulsive behaviors in response ▪ Distress affects day-to-day functioning TREATMENT MEDICATIONS ▪ SSRIs and other antidepressants PSYCHOTHERAPY ▪ Cognitive behavioral therapy BODY FOCUSED REPETITIVE DISORDERS osms.it/repetitive-disorders PATHOLOGY & CAUSES TYPES Excoriation disorder ▪ Characterized by compulsive skin-picking ▪ Can lead to infection/tissue damage Trichotillomania ▪ Characterized by compulsive hair-pulling CAUSES ▪ High comorbidity with other mood disorders; stress-related ▪ Trichotillomania: genetic 718 OSMOSIS.ORG SIGNS & SYMPTOMS ▪ Purposeful skin-picking (excoriation) or hair-pulling (trichotillomania) with associated damage ▪ Causes distress in other areas of life DIAGNOSIS ▪ Not explained by any other condition/ substance

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Body dysmorphic disorder

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Questions

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A 12-year-old girl is brought to her pediatrician's office because of an elongated nose. She reports that her nose is too big, long, and ugly. She describes it as "disgusting" and is obsessed with getting a rhinoplasty. Her parents state that she has been harassing them for months for the operation and constantly checks her nose in the mirror. The patient states that she cannot sleep at night and spends hours looking over fashion magazines. She says that she cannot stand the sight of her own nose and will try to break it if her parents will not pay for her rhinoplasty. Head, ear, eyes, and neck examination shows an average sized nose with no obvious functional defects. Which of the following is the most likely diagnosis?

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