Body Dysmorphic Disorder: Phenomenology and Case Descriptions

Abstract

Thirteen cases of Body Dysmorphic Disorder (BDD) were described. There were eight males (61.5%) and five females (38.5%) with ages ranging from 16 to 37 (mean=24.7). All patients were also diagnosed as obsessive compulsive disorder (OCD), according to DSM-III-R, with the exception of one. Patients were administered the Yale Brown Obsessive Compulsive Scale, Beck Depression Inventory, Wechsler Intelligence Scale, Over-valued Ideation Scale and MMPI. The Phenomenology of BDD, its relationship to OCD, and the patients' responses to the above tests were reported. Due to the bizarreness of the symptoms and the secretiveness of the patients, it was suggested that clinicians be thoroughly aware of the disorder and inquire as to its presence during the initial consultation. Otherwise, these patients go unnoticed and they resort to treatment from dermatologists and plastic surgeons.

Clinical features of body dysmorphic disorder in adolescents and adults

“…However, it is interesting that both studies of BDD in adolescents found that most adolescents were female. This finding is consistent with several studies of adults with BDD in community and clinical settings (Rosen and Reiter, 1996;Veale et al, 1996;Faravelli et al, 1997), but differs from other adult BDD studies, which had a nearly equal gender ratio or contained more males than females (Hollander et al, 1993;Neziroglu and Yaryura-Tobias, 1993;Perugi et al, 1997;Phillips and Diaz, 1997;Bienvenu et al, 2000). It is unclear whether BDD actually affects more females than males-both adolescents and adults-or whether males with BDD are less likely to come to clinical attention or participate in a study such as ours, perhaps because it is more distressing and feels more shameful for males to reveal and discuss body image concerns.…”

Gender similarities and differences in 200 individuals with body dysmorphic disorder

“…Body dysmorphic disorder's gender ratio has also varied in clinical samples. Two previous BDD studies contained more women than men (72% of 82 subjects [17] and 76% of 50 subjects [45]), whereas 3 studies contained more men than women (62% of 13 subjects [50], 62% of 50 subjects [51], and 59% of 58 subjects [12]), and the largest previous study (n = 188) contained a nearly equal proportion of women (49%) and men (51%) [11]. The clinical studies contained samples of convenience and may therefore have various biases.…”

Cognitive therapy in the treatment of body dysmorphic disorder

“…This is typical of the BDD population (Phillips, 1991;Neziroglu and Yaryura-Tobias, 1993a,b;Phillips et al, 1993). As is also common, all patients had repeatedly sought nonpsychiatric treatment with little or no relief (Neziroglu and Yaryura-Tobias, 1993a;Phillips et al, 1993) and all experienced secondary depression and anxiety (APA, 1994). Due to the similarities between the current sample and those described within the literature, results generated from this research appear to be applicable to the body dysmorphic population.…”

“…Any body part or several parts may be a source of concern. One, body part however, usually acquires prominence and arouses the most distress though focus may switch, to different features over the course of the disorder (Phillips, 1991;Neziroglu and Yaryura-Tobias, 1993a).…”

“…Due to the inordinate amount of time spent either thinking about or trying to 'fix' the deformity, other aspects of life may be ignored (Phillips, 1991) resulting in impaired social, marital, and occupational functioning (Hay, 1970;Braddock, 1982;Marks and Mishan, 1988). Psychological help is typically sought as a last resort in response to prolonged social isolation, inability to function at work or in school, or insistence by members of the patient's immediate family (Neziroglu and Yaryura-Tobias, 1993a).…”