Pharmacological Treatment of Body Dysmorphic Disorder

Abstract

Body dysmorphic disorder is a challenging disorder that manifests as erroneously perceived flaws in one's physical appearance and repetitive behaviors in response to appearance concerns. This disorder is also frequently comorbid with other psychiatric disorders, including major depressive disorder and autism spectrum disorder. It is currently understood to arise from a combination of biological, psychological, and environmental factors. Treatment of body dysmorphic disorder typically consists of a combination of pharmacotherapy and cognitive behavioral therapy. However, not all patients respond to treatment, and BDD symptoms remain even in those who do respond. This review outlines current pharmacological and neuromodulation treatments for body dysmorphic disorder, and suggests directions for future studies of novel treatments such as augmentation with atypical antipsychotics and the use of intranasal oxytocin in cases of body dysmorphic disorder that show residual symptomatology even with tailored monotherapy. There is emerging evidence suggesting that non-invasive neurostimulatory techniques, such as repetitive transcranial magnetic stimulation, may be of value in treatment-resistant cases.

Psychopharmacology in dermatology: Treatment of primary psychiatric conditions in dermatology

“…The severity of the disorder, the history of recurrence after discontinuation of the drug, and the presence of selfharming or suicidal thoughts, are elements guiding the indefinite use of the drug in the lowest dose that produced improvement. 19 Excoriation disorder and trichotillomania (other body focused repetitive behavior disorders). Excoriation disorder is characterized by the need or urge to scratch, pinch, touch, rub, rub, squeeze, bite, or dig the skin.…”

“…These recommendations suggest keeping the medication for years. The severity of the disorder, the history of recurrence after discontinuation of the drug, and the presence of self‐harming or suicidal thoughts, are elements guiding the indefinite use of the drug in the lowest dose that produced improvement 19 …”

Delusional Misidentification Syndromes: Psychopathology and Culture

“…Estimates of up about 2% of the population may suffer from BDD, while the prevalence may be higher among college students and clinical populations at around 5%. Outpatient psychiatric populations have been estimated to be 5.8% while inpatient psychiatric populations could be as high as 7.4% (Hong et al, 2019). However, it seems safe to assume that more extreme cases, for instance where a person makes an attempt to amputate a limb, are far fewer.…”

“…With regard to psychotherapeutic treatments cognitive behavior therapy (CBT) seems to be the most common modality and is generally thought to be effective in treating BDD (Rasmussen et al, 2017). However, a number of authors state that CBT is not effective for everyone suffering from BDD (Hong et al, 2019;Weingarden et al, 2019).…”

“…The administration of intranasal oxytocin was found to reverse resting state abnormality (Grace et al, 2019). Hong et. al.…”