Body Dysmorphic Disorder

Humans are visual beings, with a long history of self-adornment and attempts
to change appearance to conform with social or religious ideals, to try
to stand out from the crowd, or simply to look ‘‘good.’’ Indeed, few could
deny some degree of preoccupation with appearance. For some, however,
dissatisfaction with appearance reaches an intensity that is pathologic in
that it causes significant distress or impairs functioning in vocational or
social domains. This psychiatric disorder, initially termed ‘‘dysmorphophobia,’’
was described by the Italian physician Morselli in the late
nineteenth century and has subsequently been labeled, inter alia, ‘‘dermatologic
hypochondriasis,’’ ‘‘beauty hypochondria,’’ and ‘‘worry about being
ugly’’ [1]. In 1987 it entered the official United States psychiatric nosology
in the Diagnostic and Statistical Manual of Mental Disorders III-revised
(DSM-IIIR) under the label ‘‘body dysmorphic disorder’’ (BDD) [2]. Its relevance
to this issue of the Psychiatric Clinics of North America lies in its links
with obsessive-compulsive disorder (OCD) and the consideration being
given to its being part of the obsessive-compulsive (OC) spectrum.