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Katharine A. Phillips - One of the best experts on this subject based on the ideXlab platform.
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Body Dysmorphic Disorder
New Oxford Textbook of Psychiatry, 2020Co-Authors: Megan M. Kelly, Katharine A. PhillipsAbstract:Body Dysmorphic Disorder (BDD) is a common and unusually severe mental illness, characterized by distressing or impairing preoccupations with non-existent or slight defects in one’s physical appearance, as well as compulsive behaviours, that aim to examine, improve, hide, or obtain reassurance about the perceived defects. BDD is associated with poor quality of life and marked functional impairment, as well as high rates of suicidal ideation and behaviours. Although BDD is often under-recognized in clinical settings, both pharmacotherapy and psychosocial interventions are effective at reducing BDD symptoms and distress. This chapter presents information on the phenomenology, clinical characteristics, diagnosis, epidemiology, pathogenesis, course, and treatment of BDD.
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Body Dysmorphic Disorder
New Oxford Textbook of Psychiatry, 2012Co-Authors: Katharine A. PhillipsAbstract:Body Dysmorphic Disorder (BDD), also known as dysmorphophobia, is a relatively common, severe, and sometimes difficult-to-treat condition that has been described for more than a century. BDD consists of a distressing or impairing preoccupation with an imagined or slight defect in one's physical appearance. BDD is classified as a separate Disorder in DSM-IV and a type of hypochondriasis in ICD-10. This Disorder can cause severe distress and notably impaired functioning. In addition, risk behaviours—suicidality, violence, problematic substance use, and compulsive tanning—appear common in BDD. Despite its severity, BDD is underrecognized in clinical settings.
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Childhood abuse and neglect in Body Dysmorphic Disorder.
Child abuse & neglect, 2006Co-Authors: Elizabeth R. Didie, William Menard, Christina Fay, Christina Tortolani, Courtney G. Pope, Katharine A. PhillipsAbstract:Objective No published studies have examined childhood abuse and neglect in Body Dysmorphic Disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this Disorder.
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Pathological skin picking in individuals with Body Dysmorphic Disorder
General hospital psychiatry, 2006Co-Authors: Jon E. Grant, William Menard, Katharine A. PhillipsAbstract:Objective The objective of this study was to examine the prevalence and clinical correlates of pathological skin picking (PSP) in a large sample of individuals with Body Dysmorphic Disorder (BDD).
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Placebo-controlled study of pimozide augmentation of fluoxetine in Body Dysmorphic Disorder.
The American journal of psychiatry, 2005Co-Authors: Katharine A. PhillipsAbstract:OBJECTIVE: Although Body Dysmorphic Disorder often responds to serotonin reuptake inhibitors (SRIs), most patients do not respond or respond only partially. However, placebo-controlled studies of augmentation of SRIs have not been done. Furthermore, although 40%–50% of patients are delusional, studies of antipsychotic medications have not been done. METHOD: Twenty-eight patients with Body Dysmorphic Disorder or its delusional variant participated in an 8-week, placebo-controlled, double-blind, parallel-group study of pimozide augmentation of fluoxetine. RESULTS: Pimozide was not more effective than placebo: two (18.2%) of 11 subjects responded to pimozide and three (17.6%) of 17 subjects responded to placebo. There was no significant effect of baseline delusionality on endpoint severity of Body Dysmorphic Disorder. Delusionality did not decrease significantly more with pimozide than placebo. CONCLUSIONS: Pimozide augmentation of fluoxetine treatment for Body Dysmorphic Disorder was not more effective than...
Sabine Wilhelm - One of the best experts on this subject based on the ideXlab platform.
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Treatment of an Adult with Body Dysmorphic Disorder
Clinical Handbook of Obsessive-Compulsive and Related Disorders, 2015Co-Authors: Angela Fang, Rachel Schwartz, Sabine WilhelmAbstract:Body Dysmorphic Disorder (BDD) is defined as a preoccupation with a perceived flaw in appearance. BDD is associated with functional impairment and poor quality of life, especially when left untreated. In this chapter, we describe the treatment of an adult with BDD. We use a modular cognitive behavioral therapy (CBT) protocol developed by (Wilhelm et al., A cognitive behavioral treatment manual for Body Dysmorphic Disorder, Guilford, New York, 2013), which has been demonstrated to be efficacious for adults with BDD. Specifically, we aim to highlight treatment techniques that were tailored to this case and the clinical features that represent the major challenges of working with this population. We also illustrate how to implement a full course of treatment while demonstrating key practice points for the effective clinician.
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Body Dysmorphic Disorder.
The Psychiatric clinics of North America, 2014Co-Authors: Angela Fang, Natalie L Matheny, Sabine WilhelmAbstract:Body Dysmorphic Disorder (BDD) can be a severe and often debilitating psychiatric Disorder that has been largely under-recognized and underdiagnosed. Pharmacologic and nonpharmacologic treatment options are available but limited. This review aims to provide an updated overview of the psychopathology and epidemiology of BDD, with an emphasis on current pharmacologic and nonpharmacologic treatment options for BDD.
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Body Dysmorphic Disorder and obsessive-compulsive Disorder: similarities, differences and the classification debate.
Expert review of neurotherapeutics, 2008Co-Authors: Anne Chosak, Luana Marques, Jennifer L. Greenberg, Eric Jenike, Darin D. Dougherty, Sabine WilhelmAbstract:Obsessive-compulsive Disorder and Body Dysmorphic Disorder have many similarities in clinical presentation. Obsessive-compulsive Disorder has historically been considered an anxiety Disorder, whereas Body Dysmorphic Disorder has been grouped among the somatoform Disorders. Researchers in these areas are currently debating whether the similarities warrant the inclusion of Body Dysmorphic Disorder within a proposed category of obsessive-compulsive spectrum Disorders. This article describes the association between obsessive-compulsive Disorder and Body Dysmorphic Disorder as evidenced by the emerging literature, and presents theoretical and clinical implications of this association.
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Cognitive Theory of Body Dysmorphic Disorder
Cognitive Approaches to Obsessions and Compulsions, 2002Co-Authors: Sabine Wilhelm, F. NezirogluAbstract:Publisher Summary This chapter discusses cognitive theory of Body Dysmorphic Disorder. Body Dysmorphic Disorder (BDD), a preoccupation with an imagined or slight defect in appearance, has only recently received empirical attention. Most people suffering from BDD are severely distressed by their supposed flaws and describe their preoccupations as painful and tormenting. About 90 percent of the BDD suffers perform repetitive behaviors intended to check, improve, or hide the supposed defect. These behaviors include checking the perceived flaw in mirrors or other reflecting surfaces, such as store windows or car bumpers. Many individuals camouflage the perceived flaw with make-up, hair, Body position, or clothing. BDD is also associated with high levels of occupational and social disability, including unemployment, absenteeism, lost productivity, and marital dysfunction. BDD sufferers may have maladaptive assumptions with respect to the meaning of their defect. However, an integration of various cognitive approaches may be very fruitful. Cognitive interventions may be particularly beneficial if it focuses on the basic assumptions about the self, the world, and the future.
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Prevalence of Body Dysmorphic Disorder in a community sample of women.
The American journal of psychiatry, 2001Co-Authors: Michael W. Otto, Sabine Wilhelm, Lee S. Cohen, Bernard L. HarlowAbstract:Objective: In a large population-based study, the authors examined the prevalence and correlates of Body Dysmorphic Disorder, a debilitating and chronic condition characterized by an imagined defect in appearance. Method: Rates and diagnostic correlates of Body Dysmorphic Disorder were examined by using data from the Harvard Study of Moods and Cycles. This study used in-person structured clinical interviews to characterize the diagnostic status of a population-based, cross-sectional sample of 318 depressed and 658 nondepressed women between the ages of 36 and 44 who were selected from seven Boston metropolitan area communities. Results: The presence of Body Dysmorphic Disorder was significantly associated with the presence of major depression and anxiety Disorders. The authors estimated the overall point prevalence of Body Dysmorphic Disorder as 0.7% in women in this age range in the community. Conclusions: The authors found that the presence of Body Dysmorphic Disorder was linked to the presence of major depression and anxiety Disorders, which is similar to findings in clinical studies. Their estimate of the point prevalence of Body Dysmorphic Disorder is consistent with data from a community-based sample of Italian women and suggests a prevalence similar to that of other serious psychiatric Disorders in women (e.g., schizophrenia and drug abuse and dependence). These prevalence data encourage the further development of treatment options for this debilitating condition.
David Castle - One of the best experts on this subject based on the ideXlab platform.
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Body Dysmorphic Disorder in men.
Australian family physician, 2015Co-Authors: Andrea Phillipou, David CastleAbstract:Background: Body Dysmorphic Disorder (BDD) is a condition associated with a perceived defect or flaw in physical appearance and repetitive behaviours related to this perceived imperfection. BDD affects men and women approximately equally, although a variant called muscle dysmorphia occurs more frequently in males. Objectives: The aim of this article is to provide general practitioners (GPs) with information related to the identification and management of individuals with BDD, especially males. Discussion: Diagnostic features, clinical presentation and screening tools for BDD are discussed. Recommendations for appropriate treatment and support are also supplied.
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An update on Body Dysmorphic Disorder
Current opinion in psychiatry, 2006Co-Authors: David Castle, Susan L. RossellAbstract:PURPOSE OF REVIEW: The present review provides an update on current research into Body Dysmorphic Disorder. RECENT FINDINGS: Recent findings can be considered under four groupings: the classification of Body Dysmorphic Disorder, its current inclusion under the somatoform Disorders, and its relationship to obsessive compulsive Disorder and other obsessive compulsive spectrum Disorders; the psychotic 'variant' of Body Dysmorphic Disorder, and whether it is simply a more severe form of the nonpsychotic type; the cognitive aspects of Body Dysmorphic Disorder; and the treatment of Body Dysmorphic Disorder, both in terms of pharmacological and psychological parameters. SUMMARY: Body Dysmorphic Disorder does not sit comfortably in the somatoform Disorder category, and there is a good case for it being considered part of the obsessive compulsive spectrum, although it is not merely a subtype of obsessive compulsive Disorder. Insight into the illness suggests that it represents a spectrum of Disorders, and a categorical delineation of 'psychotic' and 'nonpsychotic' variants cannot be supported. We are beginning to understand more about the neurocognitive aspects of Body Dysmorphic Disorder, but more research is required to assess which deficits/aberrations (if any) are exclusive to Body Dysmorphic Disorder as an entity, and which are a reflection of broader phenomenological manifestations. Finally, the mainstay of treatment for Body Dysmorphic Disorder remains behaviour/cognitive behaviour therapy and serotonin reuptake inhibitors; much more work is required to identify effective interventions for those patients who fail to respond to these treatment modalities.
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Body Dysmorphic Disorder--a fear of imagined ugliness.
Australian family physician, 2003Co-Authors: Don E. Jefferys, David CastleAbstract:BACKGROUND: Body Dysmorphic Disorder (BDD) is a distressing and impairing illness characterised by an intense time consuming preoccupation with an imagined or slight defect in appearance of a Body part or parts. OBJECTIVE: This article outlines the characteristic features and treatment approaches for BDD and suggests screening techniques that can be usefully applied in the general practice setting. DISCUSSION: Body Dysmorphic Disorder has been shown to be common and chronic yet goes under recognised as the patient is often secretive about their distress. In an endeavour to alleviate the distress, time consuming rituals are performed that are either without effect or paradoxically may exacerbate the distress. Recent treatment studies show that the selective serotonin reuptake inhibitors and cognitive behavioural therapy, used simultaneously or alone, can be beneficial in alleviating the distress and impairment associated with the condition. (author abstract)
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Body Dysmorphic Disorder in men: Psychiatric treatments are usually effective
BMJ (Clinical research ed.), 2001Co-Authors: Katharine A. Phillips, David CastleAbstract:Body image isn't just a women's problem. Many studies reveal that a surprisingly high proportion of men are dissatisfied with, preoccupied with, and even impaired by concerns about their appearance.1 One American study, for example, found that the percentage of men dissatisfied with their overall appearance (43%) has nearly tripled in the past 25 years and that nearly as many men as women are unhappy with how they look.1 A more severe form of Body image disturbance—Body Dysmorphic Disorder or dysmorphophobia—is an underrecognised yet relatively common and severe psychiatric Disorder.2 Body Dysmorphic Disorder affects as many men as women 3 4 and consists of a preoccupation with an imagined or slight defect in appearance that causes clinically significant distress or impairment in functioning. Patients with Body Dysmorphic Disorder often present to non-psychiatric physicians, with reported rates of 12% in dermatology settings and 7-15% in cosmetic surgery settings.5 Although the symptoms of Body Dysmorphic Disorder might …
Eric Hollander - One of the best experts on this subject based on the ideXlab platform.
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Pharmacological Treatment of Body Dysmorphic Disorder
Current neuropharmacology, 2019Co-Authors: Kevin Hong, Vera Nezgovorova, Genoveva Uzunova, Danya Schlussel, Eric HollanderAbstract: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.
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Pharmacotherapy in Body Dysmorphic Disorder: relapse prevention and novel treatments.
Expert opinion on pharmacotherapy, 2019Co-Authors: Nancy Dong, Kevin Hong, Vera Nezgovorova, Eric HollanderAbstract:Introduction: Body Dysmorphic Disorder is a debilitating Disorder that often presents with significant delusionality, low insight, and both medical and psychiatric comorbidities, presenting a challenge for treatment and long-term management. Its typically chronic course requires that therapy be continued indefinitely, but only a few studies of long-term pharmacotherapeutic management exist. Areas covered: The authors discuss the current understanding of Body Dysmorphic Disorder, focusing specifically on: epidemiology, clinical presentation, challenges in treatment, treatment options, and the importance of the further study of the long-term management of the Disorder. Expert opinion: Serotonin reuptake inhibitors are the established drug of choice in patients with Body Dysmorphic Disorder. Initial studies suggest that other agents such as augmentation antipsychotic medication may also be of use in combination with serotonin reuptake inhibitors, but there is a lack of studies comparing new treatments to serotonin reuptake inhibitors. Due to the chronic nature of Body Dysmorphic Disorder, further research is needed to clarify the role of pharmacotherapy in long-term management and relapse prevention. Future studies should explore the long-term use of therapies and combinations of different therapeutics with the goal of effectively managing this debilitating, chronic condition.
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Diagnosis and treatment of Body Dysmorphic Disorder in adolescents.
Current psychiatry reports, 2002Co-Authors: Sallie Jo Hadley, Jennifer L. Greenberg, Eric HollanderAbstract:Body Dysmorphic Disorder (BDD) is an underrecognized and underdiagnosed problem that is relatively common among adolescents. Although the onset of the Disorder occurs in adolescence, BDD research in child and adolescent psychiatry is relatively limited. Body Dysmorphic Disorder has a high rate of co-morbidity with depression and suicide, which indicates important implications for prompt diagnosis and treatment in adolescents with BDD. Effective treatment options include cognitive behavioral therapy (CBT) and pharmacotherapy with serotonin reuptake inhibitors (SRIs). This paper provides a brief overview of BDD in adolescents, presents and evaluates the most recent literature on approaches to diagnosis and treatment, and highlights some of the characteristics that distinguish BDD from other Disorders such as obsessive-compulsive Disorder, social phobia, depression, and eating Disorders.
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Body Dysmorphic Disorder in the DSM-IV field trial for obsessive-compulsive Disorder.
The American journal of psychiatry, 1995Co-Authors: Daphne Simeon, Eric Hollander, Dan J. Stein, Lisa J. Cohen, Bonnie AronowitzAbstract:Objective This study investigated the prevalence and phenomenology of Body Dysmorphic Disorder in patients with obsessive-compulsive Disorder. Method The authors studied 442 patients who participated in the DSM-IV field trial for obsessive-compulsive Disorder. Results Twelve percent (N = 51) of the patients had a lifetime comorbid diagnosis of Body Dysmorphic Disorder. Patients with and without Body Dysmorphic Disorder did not differ in demographic characteristics of obsessive-compulsive symptoms. Patients with obsessive-compulsive Disorder and Body Dysmorphic Disorder had more anxious, impulsive, and schizotypal features than patients with obsessive-compulsive Disorder alone. Age at onset was similar for the two Disorders, and severity correlated. However, insight was significantly more impaired for Body Dysmorphic Disorder than for obsessive-compulsive Disorder. Conclusions As previously thought, these findings suggest that the two Disorders are strongly related but also have differences that require further investigation.
F. Neziroglu - One of the best experts on this subject based on the ideXlab platform.
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An Intensive Cognitive Behavioral Treatment for Body Dysmorphic Disorder
Clinical Case Studies, 2018Co-Authors: F. Neziroglu, Brittany Bonasera, Desiree CurcioAbstract:Body Dysmorphic Disorder affects 2.4% of the U.S. adult population, with the most common age of onset between 12 and 13 years. However, research in the area of adolescent BDD is minimal. This case ...
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A Proposed Learning Model of Body Dysmorphic Disorder
Standard and Innovative Strategies in Cognitive Behavior Therapy, 2012Co-Authors: F. Neziroglu, Lauren M. MancusiAbstract:While it is common for individuals to have concerns about their appearance, individuals with Body Dysmorphic Disorder (BDD) experience a marked distress that often results in time-consuming rituals, social anxiety, and depression among other debilitating effects. Body Dysmorphic Disorder (BDD) is a severe and debilitating Disorder that is characterized by a perceived physical defect that causes significant impairments in everyday functioning (American Psychiatric Association, 2000). BDD was first mention in the late 1800’s (Morselli, 1891). It was described as dysmorphophobia and referred to a strong emotional response (e.g. anxiety) to certain changes in physical appearance. Body Dysmorphic Disorder was not mentioned again until the advent of the third Diagnostic and Statistical Manual for Mental Disorders (DSM III), in which BDD was listed as a somotaform Disorder (American Psychiatric Association, 1987). While BDD remains classified as a somotaform Disorder in the current edition of the DSM (DSM IV-TR), more recently it has been conceptualized as an obsessive-compulsive related Disorder (OCRD). Like other OCRD, BDD involves symptoms of obsessions and compulsions.
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Body Dysmorphic Disorder
Encyclopedia of Adolescence, 2011Co-Authors: D. Mckay, F. NezirogluAbstract:Background: Body Dysmorphic Disorder is a somatoform Disorder, which is characterized by the patient’s preoccupation with a minor or imagined apperance defect. It has a reported prevalence of 0.7 % to 2.3 % in the general population. Prevalence among patients seeking aesthetic surgery is 6 % to 15 %. Body Dysmorphic Disorder appears to affect men and women equally. Comorbidity with other psychiatric Disorders is frequent. Cosmetic medical treatment is ineffective in treating Body Dysmorphic Disorder. Treatment with selective serotonin reuptake inhibitors and cognitive behavioral therapy appear to be more effective. Conclusions: Body Dysmorphic Disorder is a common psychiatric Disorder, which needs to be addressed by the medical profession and the general public. By searching Medline, we found 577 articles matching »Body Dysmorphic Disorder .The Disorder is well known by general public of Western countries, especially USA, but is less known in Slovenia. As patients often pursue cosmetic procedures and aesthetic surgery, it is important that medical staff, especially providers of cosmetic surgical and minimally invasive treatments, are able to identify them and refer them for appropriate mental health care
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Body Dysmorphic Disorder: A Treatment Manual
2010Co-Authors: David Veale, F. NezirogluAbstract:About the authors. Preface. Acknowledgements. Part A: Knowledge and Theory of Body DysmorphicDisorder. 1. The diagnosis of Body Dysmorphic Disorder. 2. History of Body Dysmorphic Disorder. 3. Epidemiology and presentation of BDD. 4. Descriptive psychopathology of BDD. 5. Psychogenic excoriation. 6. Psychological aspects of cosmetic procedures. 7. Risk factors in the development of BDD. 8. Neurobiological aspects of BDD. 9. Learning theory models of BDD. 10. A cognitive behavioral model of BDD. 11. Evidence for cognitive behavior therapy in BDD. 12. Evidence for pharmacotherapy in BDD. Part B: Assessment and Therapy. 13. Assessment. 14. Engagement and formulation. 15. Advice on cosmetic procedures. 16. Imagery rescripting. 17. Modifying attentional biases. 18. Modifying cognitive processes in BDD. 19. Avoidance, compulsive, and safety-seeking behaviors. 20. Modifying appraisals. 21. Habit reversal for psychogenic excoriation. 22. Behavioral activation for depression in BDD. 23. Pharmacotherapy. Appendix 1 Diagnostic interviews and assessment scales. Appendix 2 Leaflets and forms used during therapy. Appendix 3 Resources for BDD. References. Index.
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Cognitive Theory of Body Dysmorphic Disorder
Cognitive Approaches to Obsessions and Compulsions, 2002Co-Authors: Sabine Wilhelm, F. NezirogluAbstract:Publisher Summary This chapter discusses cognitive theory of Body Dysmorphic Disorder. Body Dysmorphic Disorder (BDD), a preoccupation with an imagined or slight defect in appearance, has only recently received empirical attention. Most people suffering from BDD are severely distressed by their supposed flaws and describe their preoccupations as painful and tormenting. About 90 percent of the BDD suffers perform repetitive behaviors intended to check, improve, or hide the supposed defect. These behaviors include checking the perceived flaw in mirrors or other reflecting surfaces, such as store windows or car bumpers. Many individuals camouflage the perceived flaw with make-up, hair, Body position, or clothing. BDD is also associated with high levels of occupational and social disability, including unemployment, absenteeism, lost productivity, and marital dysfunction. BDD sufferers may have maladaptive assumptions with respect to the meaning of their defect. However, an integration of various cognitive approaches may be very fruitful. Cognitive interventions may be particularly beneficial if it focuses on the basic assumptions about the self, the world, and the future.