KEY NOTES CHAPTER 9: AESTHETIC SURGERY - Body dysmorphic disorder.

Question 0

How can you screen for BDD?

Answer 0

• Assess patient motivations and expectations.
• Psychiatric history (depression, anxiety, anger, violence, suicidal ideation up to 78%).
• Concerns about body image.
• Symptoms of BDD, compulsive behaviours, preoccupations, camouflaging areas of concern, social avoidance, comparing themselves to others, constant ‘skin-picking’.
• Insight usually poor, remission is rare. Cognitive behavioural therapy and SSRIs may help, not surgery.

Question 1

What is body dysmorphic disorder?

Answer 1

A psychiatric disorder characterised by extreme preoccupation with appearance.
3 diagnostic criteria:
1. Preoccupation with an imagined or slight defect in appearance (and degree of concern is extreme).
2. Marked distress or impairment in social, occupational or other areas of functioning resulting from the appearance preoccupation.
3. The preoccupation is not attributable to another psychiatric disorder (such as anorexia nervosa).

Most patients will experience 1, therefore 2 is useful differentiator for BDD.