An update on body dysmorphic disorder

Current Opinion in Psychiatry

Volumn 19, Issue 1, 2006, Pages 74-78

  Castle, David J ^a   Rossell, Susan L ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

Body dysmorphic disorder; Cognition; Cognitive behaviour therapy; Insight; Obsessive compulsive spectrum; Psychosis

Indexed keywords

CITALOPRAM; CLOMIPRAMINE; DESIPRAMINE; FLUOXETINE; PIMOZIDE; PLACEBO;

BEHAVIOR THERAPY; BODY DYSMORPHIC DISORDER; CLINICAL TRIAL; COGNITIVE DEFECT; COGNITIVE THERAPY; DISEASE ASSOCIATION; DISEASE CLASSIFICATION; DISEASE SEVERITY; HUMAN; META ANALYSIS; OBSESSIVE COMPULSIVE DISORDER; PHENOMENOLOGY; PSYCHOPHARMACOTHERAPY; PSYCHOSIS; PSYCHOTHERAPY; REVIEW; SOMATOFORM DISORDER; SYSTEMATIC REVIEW; TREATMENT INDICATION; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; PSYCHOLOGICAL ASPECT;

COGNITION DISORDERS; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; HUMANS; OBSESSIVE-COMPULSIVE DISORDER; SOMATOFORM DISORDERS;

EID: 33646835745     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.yco.0000196159.06165.31     Document Type: Review

References (29)

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (3rd ed, revised). Washington, DC: American Psychiatric Association; 1987.
2. Castle DJ, Molton M, Hoffman K, et al. Correlates of dysmorphic concern in people seeking cosmetic enhancement. Aust N Z J Psychiatry 2004; 38:439-444. This study investigated BDD and more broadly 'dysmorphic concern' in people attending cosmetic physicians. Only 2.9% of subjects had BDD but many more expressed generalized over-concern with physical appearance, and this was associated with mood disorder, social anxiety and impairment in work and social functioning.
3. Phillips KA, Castle DJ. Body dysmorphic disorder. In: Castle DJ, Phillips KA, editors. Disorders of body image. Hampshire, UK: Wrightson Biomedical; 2002.
4. Mayou R, Kirmayer L, Simon G, et al. Somatoform disorders: time for a new approach in DSM-V. Am J Psychiatry 2005; 162:847-855. This is a thoughtful review of the somatoform disorder category in DSM. The authors suggest an alternative approach that might be adopted in DSM-V in which a number of the disorders be subsumed under other categories and disorders that are characterized exclusively by somatic symptoms be coded on axis III. It is a provocative article that raises important issues with respect to the classification of the somatoform disorders in general.
5. Frare F, Perugi G, Ruffulo G, Toni C. Obsessive-compulsive disorder and body dysmorphic disorder: a comparison of clinical features. Eur Psychiatry 2004; 19:292-298. This is a comparison of patients with 'pure' BDD as opposed to 'pure' OCD and 'comorbid' BDD and OCD. The differences in comorbidity suggest that BDD is not simply a subtype of OCD but is related also to a number of other disorders, including social phobia.
6. Lochner C, Stein D. Heterogeneity of obsessive-compulsive disorder: a literature review. Harv Rev Psychiatry 2003; 11:113-132.
7. Keuneman RJ, Pokos V, Weerasundera R, Castle DJ. Antipsychotic treatment in obsessive-compulsive disorder: a literature review. Aust N Z J Psychiatry 2005; 39:336-343. This is a review of the literature of antipsychotic treatment in OCD that reinforces the notion that OCD is a heterogeneous group with differential treatment responses. This has implications for our understanding of the obsessive compulsive spectrum disorders, including BDD.
8. Aouizerate B, Guehl D, Cuny E, et al. Pathophysiology of obsessive-compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology. Prog Neurobiol 2004; 72:195-221. This is a comprehensive review of the pathophysiology of OCD, with an integration and discussion of various models underpinning OCD. It is a useful addition to the literature, which serves to inform our conceptualization of the obsessive compulsive spectrum.
9. Grant JE, Kim SW, Eckert ED. Body dysmorphic disorder in patients with anorexia nervosa: prevalence, clinical features and delusionality of body image. Int J Eating Disord 2002; 32:291-300.
10. Grant JE, Phillips KA. Is anorexia nervosa a subtype of body dysmorphic disorder? Probably not, but read on. Harv Rev Psychiatry 2004; 12:123-126. This brief review of anorexia and its relationship to BDD highlights similarities and differences between the disorders and asks questions about their interrelatedness.
11. Bienvenu OJ, Samuels JF, Riddle MA, et al. The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry 2000; 48:287-293.
12. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: American Psychiatric Association; 1994.
13. Phillips KA, McElroy SL, Keck PE, et al. A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases. Psychopharmacol Bull 1994; 30:179-186.
14. Awad A, Voruganti L. Body weight, image and self-esteem evaluation questionnaire: development and validation of a new scale. Schizophr Res 2004; 70:63-67. This is a description of a new questionnaire designed to quantify the social impact of weight gain, and a preliminary validation of this questionnaire.
15. Phillips KA, Pinto A, Jain S. Self-esteem in body dysmorphic disorder. Body Image 2004; 385-390. In this investigation of the Rosenberg Self-Esteem Scale, conducted in 93 BDD patients who were participating in a placebo-controlled trial of fluoxetine, there was significant improvement in self-esteem in fluoxetine responders compared with nonresponders.
16. Phillips KA. Psychosis in body dysmorphic disorder. J Psychiatr Res 2004; 38:63-72. This excellent article provides an overview of psychosis in BDD and proposes that a dimensional model might be a more appropriate approach to conceptualizing insight in disorders such as BDD, OCD, hypochondriasis and anorexia nervosa.
17. Eisen JL, Phillips KA, Coles ME, Rasmussen SA. Insight in obsessive compulsive disorder and body dysmorphic disorder. Compr Psychiatry 2004; 45:10-15. This is a comparison of insight in 64 outpatients with OCD and 85 with BDD, using the Brown Assessment of Beliefs Scale. BDD patients had poorer insight globally and on various subscales.
18. Phillips KA. Body dysmorphic disorder, in somatoform and factitious disorders. Phillips KA, editor. Washington, DC: American Psychiatric Press; 2001. pp. 67-94.
19. Phillips KA. Olanzapine augmentation of fluoxetine in body dysmorphic disorder [letter]. Am J Psychiatry 2005; 162:1022.
20. Phillips KA. Placebo-controlled study of pimozide augmentation of fluoxetine in body dysmorphic disorder. Am J Psychiatry 2005; 162:377. This study looked at pimozide augmentation of fluoxetine in 28 patients with BDD over 8 weeks. There was no significant difference in outcome in those patients on pimozide compared with those on placebo.
21. Buhlmann U, Wilhelm S, McNally RJ, et al. Interpretative biases for ambiguous information in body dysmorphic disorder. CNS Spectr 2002; 7:435-443.
22. Buhlmann U, McNally RJ, Etcoff NL, et al. Emotion recognition deficits in body dysmorphic disorder. J Psychiatr Res 2004; 38:201-206. This study assessed the ability to identify facial expressions of emotion and to discriminate single facial features in BDD patients as compared with OCD patients and healthy control individuals. The BDD group was less accurate than the healthy control group but not the OCD group in identifying facial expressions of emotion, but the BDD group more often misidentified emotion expressions as angry.
23. Buhlmann U, Etcoff N, Wilhelm S. Emotion recognition bias for contempt and anger in body dysmorphic disorder. J Psychiatr Res 2005 (in press).
24. Osman S, Cooper M, Hackmann A, Veale D. Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory 2004; 12:428-436. Eighteen BDD patients and 18 healthy control individuals were compared on the assessment of the presence and characteristics of spontaneous appearance related images. BDD patients had more negative spontaneously occurring appearance related images that were also more vivid and detailed.
25. Veale D. Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image 2004; 1:113-125. This is a detailed exposition of a cognitive behavioural model of BDD that incorporates evidence from recent studies and that tries to account for the maintenance of symptoms in BDD. The author concludes that the core of BDD is obsessive self-focused attention on a distorted body image with negative appraisals leading to ruminations and changes in mood and use of safety behaviours. The implications for psychological treatment using a cognitive behavioural model are discussed.
26. Sarwer D, Gibbons L, Crerand C. Treating body dysmorphic disorder with cognitive-behaviour therapy. Psychiatr Ann 2004; 34:934-941. This is a useful, up-to-date overview of CBT approaches to BDD.
27. Phillips KA. Treating body dysmorphic disorder using medication. Psychiatr Ann 2004; 34:945-953. This is a useful, up-to-date overview of medication treatment for people with BDD.
28. Williams J, Hadjistavropoulos T, Sharpe D. A meta-analysis of psychological and pharmacological treatments for body dysmorphic disorder. Behav Res Ther 2005 (in press).
29. Phillips KA, Albertini RS, Rasmussen SA. A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Arch Gen Psychiatry 2002; 59:381-388.