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Body dysmorphic disorder symptoms

Dysmorphophobia, originally conceptualized by Morselli in 1886, refers to a subjective feeling of ugliness or physical defect in a person of normal appearance. It also includes individuals with a minimal physical defect who react out of proportion to this defect. Dysmorphophobia is a label that has largely been used in Europe but ignored in the United States; it was originally introduced in the United States by Finkelstein and was neglected until Andreasen and Bardach brought it back into the psychiatric nomenclature. Historically, dysmorphophobia was thought of as part of monosymptomatic hypochondriasis. As discussed earlier, dysmorphophobia is not a hypochondriacal process. Hypochondriacs draw attention to themselves by saying they are not normal, whereas dysmorphophobics wish to appear normal but feel that other people notice that they are not normal. Diagnosis.In DSM-III, dysmorphophobia was categorized as an atypical somatoform disorder in the somatoform disorders section. Dysmorphophobia as a term was replaced by ‘‘body dysmorphic disorder’’ in DSM-III-R. Because the disturbance did not involve true phobic avoidance, the term was considered a misnomer. DSM-III-R classified body dysmorphic disorder as delusional in the delusional disorders (somatic subtype) section. However, in DSM-IV, a diagnosis of delusional disorder, somatic type, can be added to body dysmorphic disorder if the individual’s preoccupation with an imagined defect has delusional intensity. Even with this addition to DSM-IV, it is not clear whether body dysmorphic disorder and delusional disorder, somatic subtype, are really variants of the same disorder or are two different disorders. Clinical Description.Although much of the early information on dysmorphic disorder was based on case studies, there has been a significant increase in systematic studies of body dysmorphic disorder. Research with these patients is difficult, because they are usually seen by cosmetic or plastic surgeons and dermatologists instead of mental health professionals.

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