EpistemisDysmorphophobia
Specialty: Psychiatry.
Why it occurs
- Primary body dysmorphic disorder
- Obsessive-compulsive disorder (OCD)
- Major depression with ideation consistent with affect
- Avoidant or borderline personality disorder
- Anorexia nervosa (specifically focused on global body silhouette)
- Paranoid schizophrenia (somatic delusions)
Initial workup
Yale-Brown Body Dysmorphia Scale (BDD-YBOCS); psychiatric evaluation focused on ruling out somatic delusional ideation versus overvalued ideation; screening for isolation behaviors due to shame.
red flags
Obsessive pursuit of clandestine cosmetic surgeries or dangerous self-surgical procedures (self-surgery), active autolytic ideation due to hopelessness over the "physical defect."
Standard management
- Fluoxetine or Escitalopram — SSRIs at maximum permitted doses to reduce rumination and obsession with physical appearance
- Clomipramine — second line of great serotonergic power
- Risperidone or Aripiprazole — adjuvants if the conviction of the deformity takes on delusional overtones or borders on psychosis
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 3