Section : Conference Notes

Body Dysmorphic Disorder (BDD) (For Professionals)

Body Dysmorphic Disorder (BDD) (For Professionals)

  • frequency: it is common being present in:
  1. 11.9% of people in dermatology offices
  2. 8-15% of people in a cosmetic setting
  3. 1-2% of individuals in the population
  • Cases which can resemble Body Dysmorphoc Disorder (BDD):
  1. Stigmatization feelings in objective dematological (skin) disorders
  2. BDD behaviour in eating disorders (eg anorexia)
  3. BDD aspects in somatization disorders (eg somatoform hair loss)
  • Personality profiles of patients with BDD
  1. Paranoid type: Focused on symptoms. Has no doubts about being disfigured.
  2. Narcistic type: High level of attractiveness. Body surface always visible. Narcisstic behaviour
  3. Social phobic type: Social phobia evident, Doesn’t require contact with other individuals, Isolation (Social withdrawal)
  4. Obsessive type: Obsessive behaviour. Mirror checking behaviour evident. Anxiety
  5. Schizoid type: Schizoid isolation. Resistance to empathy. Difficulty in interaction (socially distant)
  6. Posttraumatic type: Traumatic events in early childhood or puberty. Onset after life events.
  • For patients with BDD, Depression versus non depression is 4 times more likely in dermatology and cosmetic patients. In plastic surgery, the odds are three times more likely.
  • Symptoms of BDD
  1. Mirror checking
  2. Avoidance behaviour
  3. Skin picking
  4. Low self esteem
  5. Dermatological/ plastic surgery treatment seeking
  6. Camouflaging
  7. Life style drugs
  8. Social Phobia
  9. Suicidal Ideation
  • What patients say that should raise suspicion that the patient could have BDD:
  1. “I cannot live with those symptoms”
  2. “I cannot present myself to others”
  3. “If the skin problem wasn’t there, I am quite normal and have no psychological problems”
  4. “My partner will not accept my symptoms”
  5. “Is there a cosmetic or surgical treatment ?”
  6. “Other people are looking at my skin symptoms”
  • Treatments are aimed at treating the symptoms af the perceived skin disorder:
  • If there is no influence on normal life function: treat the skin
  • Shame stigmatization: relaxation, communication skills training, psychotherapy
  • Depression: relaxation, communication skills training, psychotherapy, antidepressants
  • Somatization…


Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Gieler U. Body dysmorphic disorder. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige)

Category : body dysmorphic disorder - Modifie le 10.19.2010Category : dysmorphophobie - Modifie le 10.19.2010Category : psychodermatologie - Modifie le 10.19.2010Category : psychodermatology - Modifie le 10.19.2010