Epidemiology
Etiology
Pathophysiology
Clinical features
- Preoccupation with nonexistent or slight physical defect(s).
- Compulsive behaviors: Mirror checking, camouflage, excessive grooming, skin picking.
- Muscle dysmorphia: Belief build is too small/frail despite high muscularity.
- Persistent requests for cosmetic procedures (fails to relieve distress; often worsens it).
Diagnostics
- Clinical/DSM-5 Criteria:
- Preoccupation with perceived flaw(s) not observable or appearing slight to others.
- Repetitive behaviors or mental acts in response to appearance concerns.
- Clinically significant distress or impairment in social/occupational functioning.
- Not better explained by concerns with body fat/weight meeting criteria for an eating disorder. c
- Initial/Screening: Direct, non-judgmental questioning regarding time spent thinking about appearance and associated behaviors; screening instruments (e.g., BDD Questionnaire).
- Key Assessment: Must screen for suicidal ideation (markedly elevated risk: ~80% ideation, ~25% lifetime attempts).
- Labs/Imaging/Biopsy: None indicated.
Treatment
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