Frequently, there is no obvious abnormality in the individual’s appearance, but sometimes there is a minor flaw which is not immediately obvious to others and, in both cases, the individual’s response is excessive ( Phillips et al., 1993 Castle et al., 2006 American Psychiatric Association, 2013). CBT for BDD should be customized to address such issues as mirror use, perturbations of gaze, and misinterpretation of others’ emotions, as well as overvalued ideas about how others view the individual.īody dysmorphic disorder (BDD) is a recognized psychiatric disorder characterized by a preoccupation that some aspect of the sufferer’s physical appearance is ugly or perception of disfigurement, to the extent that they experience significant distress, disability or both. Cognitive-behavioural therapy has good evidence for efficacy for BDD, and on-line and telephone-assisted forms of therapy are showing promise. Oxytocin* may have a potential role in treating BDD, but this requires further exploration. However, large-scale randomized controlled trials are lacking and BDD is not an approved indication for these medications. If there is an inadequate response to SSRIs, various adjunctive medications can be employed including atypical antipsychotics*, anxiolytics*, and the anticonvulsant levetiracetam*. Treatment should encompass psychoeducation, particularly addressing the dangers associated with cosmetic procedures, and may require high doses of selective serotonin reuptake inhibitors* (SSRI*) and protracted periods to establish full benefit. Psychiatric comorbidities, including depression, social anxiety, and obsessive-compulsive disorder are common and impact treatment. BDD is associated with distress and impairment of functioning. Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived appearance flaw or flaws that are not observable to others.

The body broken by lynne greenberg