January 2020 By PsychDB.com

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder (BDD) is a mental disorder characterized by the obsessive idea that an aspect of one's own body part or appearance is severely flawed and warrants exceptional measures to hide or fix the dysmorphic part. Individuals are preoccupied with perceived flaws in their physical appearance that are not observable (or appear only slight to others). In addition, there are repetitive behaviors (e.g. - mirror checking, excessive grooming, skin picking, or reassurance seeking) or mental acts (e.g. - comparing one's appearance to others) in response to the appearance concerns.


The lifetime prevalence is 1-2%. There is comorbidity with depression, social phobia, and substance use.

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Symptoms of body dysmorphic disorder are generally more responsive to SSRIs and clomipramine, with a potential role for augmentation with antipsychotics. The most recent research evidence suggests that SSRIs and CBT are the best treatment approaches.[1] A trial of medication may require up to 12-16 weeks. The 2017 evidence review notes that “while dose finding studies have not been conducted in BDD, available data and clinical experience indicate that BDD often requires SSRI doses that are higher than those required to treat depression and similar to those report to treat OCD.” Of note, clinical experts in the field have suggested that dose is required to treat BDD often exceed the regulatory limit“. There is a very small case–report literature on the use of electroconvulsive therapy in body dysmorphic disorder, typically in the context of comorbid depression.

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