Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment

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Hrefna HardardottirAndri Steinthor Bjornsson

Abstract

Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with nonexistent or slight defects in appearance. BDD usually begins during childhood or adolescence. The preoccupation with the perceived appearance defect typically occurs for many hours a day and is often followed by repetitive behaviours (for example mirror checking and skin picking). The weighted prevalence of BDD in a community sample is around 2%, but it is higher in clinical settings and in cosmetic and dermatological settings. BDD leads to significant distress and/or impairment at work or school and is highly comorbid with major depressive disorder, alcohol or substance use disorder, social anxi-ety disorder and obsessive compulsive disorder and often leads to suicidal ideation. Research suggests that cognitive behavioral therapy (CBT) and SSRI medication are most effective for BDD. However, cosmetic and dermatological treatments rarely improve BDD, and are often harmful. This review contains information on how to screen and diagnose BDD. Further research on BDD and effective treatment for this often imparing disorder is needed.

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