Body dysmorphic disorder
Persons suffering from body dysmorphic disorder have a subjective believe that a feature of their body is ugly, although that feature may be normal or close to normal.
Over 50% of students suffer from body dysmorphic disorder.
The fact that the disorder responds to serotonin specific drugs points at a role played by the serotonergic system. From a dynamic aspect, sexual or emotional conflict is transferred onto unrelated body parts. This process involves suppression, distortion, symbolization and projection.
There is mental preoccupation with an imaginary defect or a slight defect in the person’s appearance. This causes emotional distress and impairs the person’s functioning. Obsessions related to the nose are common. With regards to comorbid diagnoses; depression, anxiety, obsession, schizophrenia, narcissism are frequently encountered.
Anorexia nervosa, gender identity disorder, neglect syndrome, and similar neurological disorders, somatic hallucination disorders, narcissistic personality disorder, OCD, schizophrenia, anorexia nervosa are included in the differential diagnosis.
If left untreated, body dysmorphic disorder can become chronic.
Its response to SSRI type medication is fairly high (50%). Psychotherapy helps the patient to gain insight into his neurotic emotions related to the perceived defect.