Body Dysmorphic Disorders

• A preoccupation with some imagined defect in appearance

• Actual defect, if present, appears slight to others

• Comorbid with OCD 10%

• Course lifelong

• Onset – early adolescence through 20s

• Two treatments

  • SSRIs

  • Exposure and response prevention

• Diagnostic Criteria

  • Preoccupation with one or more defects or flaws in physical appearance that are small or not observable to others

  • Repetitive behaviors

  • Significant distress

  • Preoccupation with body not better explained

• Plastic Surgery

  • Fully 76.4% had sought this type of treatment and 66% were receiving it

  • 8% to 25% of all patients who request plastic surgery may have BDD

Trichotillomania and Excoriation

• Trichotillomania: The urge to pull out one’s own hair from anywhere on the body

  • Leads to noticeable hair loss on scalp, eyebrows, arms, pubic region, etc.

  • Also called hair pulling disorder

• Excoriation (skin picking disorder) is characterized by repetitive and compulsive picking of the skin, leading to tissue damage

  • 1 to 5% prevalence rate

  • Behavioral habit reversal treatment is most effective treatment

  • Face is common target for picking