Concept

Body dysmorphic disorder

Summary
Body dysmorphic disorder (BDD), occasionally still called dysmorphophobia, is a mental disorder characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional measures to hide or fix it. In BDD's delusional variant, the flaw is imagined. If the flaw is actual, its importance is severely exaggerated. Whether the physical imperfection is real or not, thoughts about it are pervasive and intrusive and may occupy the mind of the sufferer for many hours every day, causing severe distress and impairing otherwise normal activities. BDD is classified as a somatoform disorder, and the DSM-5 categorizes BDD in the obsessive–compulsive spectrum, and distinguishes it from anorexia nervosa. BDD is estimated to affect from 0.7% to 2.4% of the population. It usually starts during adolescence and affects both men and women. The BDD subtype muscle dysmorphia, perceiving the body as too small, affects mostly males. In addition to thinking about it, the sufferer typically checks and compares the perceived flaw repetitively and can adopt unusual routines to avoid social contact that exposes it. Fearing the stigma of vanity, they usually hide this preoccupation. Commonly overlooked even by psychiatrists, BDD has been underdiagnosed. As the disorder severely impairs quality of life due to educational and occupational dysfunction and social isolation, those experiencing BDD tend to have high rates of suicidal thoughts and may attempt suicide. Dislike of one's appearance is common, but individuals with BDD have extreme misperceptions about their physical appearance. Whereas vanity involves a quest to aggrandize the appearance, BDD is experienced as a quest to merely normalize the appearance. Although delusional in about one of three cases, the appearance concern is usually non-delusional, an overvalued idea. The bodily area of focus is commonly face, skin, stomach, arms and legs, but can be nearly any part of the body, such as the penis.
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