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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Body dysmorphic disorder (BDD), also known as dysmorphophobia, consists of a distressing and impairing preoccupation with an imagined or slight defect in appearance. BDD is an underrecognized and relatively common disorder that is associated with high rates of occupational and social impairment, hospitalization, and suicide attempts. BDD is unlikely to simply be a symptom of depression, although it often coexists with depression and may be related to depression. It is important to recognize BDD in depressed patients, because missing the diagnosis can result in refractory BDD and depressive symptoms. Available data indicate that BDD may not respond to all treatments for depression and may instead respond preferentially to serotonin-reuptake inhibitors. In addition, lengthier treatment trials than those required for depression may be needed to successfully treat BDD and comorbid depression. It can be difficult and challenging to diagnose BDD in depressed patients because the symptoms are often concealed due to embarrassment and shame. This paper discusses the relationship between BDD and depression and discusses practical strategies for recognizing and treating BDD and depressive symptoms in patients with depression.
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PMID:Body dysmorphic disorder and depression: theoretical considerations and treatment strategies. 1058 87

Body dysmorphic disorder (BDD) is a distressing, impairing, and relatively common yet underrecognized disorder. This clinically focused article discusses the following diagnostic controversies and challenges associated with BDD: the underdiagnosis and misdiagnosis of BDD, the relationship between BDD and obsessive-compulsive disorder, the relationship between BDD and depression, the delusionality controversy, and whether BDD can be diagnosed in children and adolescents. This article also discusses treatment controversies and challenges associated with serotonin reuptake inhibitors, antipsychotics, cognitive-behavioral therapy, approaches to treatment-resistant BDD, and getting reluctant patients to accept psychiatric treatment.
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PMID:Body dysmorphic disorder: diagnostic controversies and treatment challenges. 1069 57

Body dysmorphic disorder (BDD) is a relatively common, distressing, and impairing disorder. Quality of life in BDD, however, has not been investigated. In this study, 62 consecutive outpatients with BDD were evaluated with the self-report Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and other scales. SF-36 scores were descriptively compared to published norms for several populations. Physical health-related quality of life scores were generally worse than general U.S. population norms and better than norms for outpatients with a medical illness or depression. However, in all mental health domains, BDD subjects' scores were notably worse than norms for the general U.S. population and for patients with depression, diabetes, or a recent myocardial infarction. More severe BDD symptoms and greater delusionality were associated with poorer mental health-related quality of life. These results indicate that patients with BDD have notably poor mental health status and mental health-related quality of life.
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PMID:Quality of life for patients with body dysmorphic disorder. 1074 82

Body dysmorphic disorder (BDD) is an underrecognized and underdiagnosed problem that is relatively common among adolescents. Although the onset of the disorder occurs in adolescence, BDD research in child and adolescent psychiatry is relatively limited. Body dysmorphic disorder has a high rate of co-morbidity with depression and suicide, which indicates important implications for prompt diagnosis and treatment in adolescents with BDD. Effective treatment options include cognitive behavioral therapy (CBT) and pharmacotherapy with serotonin reuptake inhibitors (SRIs). This paper provides a brief overview of BDD in adolescents, presents and evaluates the most recent literature on approaches to diagnosis and treatment, and highlights some of the characteristics that distinguish BDD from other disorders such as obsessive-compulsive disorder, social phobia, depression, and eating disorders.
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PMID:Diagnosis and treatment of body dysmorphic disorder in adolescents. 1191 71

The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings.
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PMID:A review of psychosocial outcomes for patients seeking cosmetic surgery. 1508 26

Body dysmorphic disorder (BDD) is a relatively common and impairing disorder. However, little is known about non-BDD symptoms and well-being in patients with this disorder. Seventy-five outpatients with DSM-IV BDD completed the Symptom Questionnaire, a validated self-report measure with four scales: depression, anxiety, somatic/somatization, and anger-hostility. Scores were compared to published norms for normal subjects and psychiatric outpatients. Participants in an open-label fluvoxamine trial completed the Symptom Questionnaire at baseline and endpoint. Compared to normal controls, BDD subjects had markedly elevated scores on all four scales, indicating severe distress and psychopathology. Compared to psychiatric patients, BDD subjects had higher scores on the depression, anxiety, and anger/hostility scales but not on the somatic/somatization scale. Scores on all scales significantly decreased with fluvoxamine. In conclusion, patients with BDD have markedly high levels of distress, are highly symptomatic, and have poor well-being in the domains of depression, anxiety, somatic symptoms, and anger-hostility. All of these symptoms significantly improved with fluvoxamine.
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PMID:Depression, anxiety, anger, and somatic symptoms in patients with body dysmorphic disorder. 1556 49

Body dysmorphic disorder is a relatively common yet long unrecognized problem affecting mainly adolescents and young adults of both sexes. It is an obsessive disease of such intensity that it interferes with daily activities. Patients typically focus on imagined major defects in the face, nose, skin or hair. Patients often seek multiple physician assessment, but body dysmorphic disorder may be disabling and even life-threatening as a result of depression and suicidal ideation. Treatment with serotonin reuptake inhibitors and cognitive behavioral therapy may be beneficial in many patients.
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PMID:Body dysmorphic disorder: more than meets the eye. 1578 46

Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression--that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications.
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PMID:Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia. 1630 6

Body dysmorphic disorder (BDD) is a somatoform disorder characterized by an excessive concern with an imagined or slight defect in appearance. BDD has been particularly studied in cosmetic surgery settings. The object of the present study is to investigate the relationship between personality disorders and dysmorphic symptoms in a group of 66 patients seeking cosmetic surgery. Assessment instruments included the following: a semistructured interview for demographic and clinical characteristics; the Structured Clinical Interview for DSM-IV, the Hamilton Depression and Anxiety Rating Scales, and the Body Dysmorphic Disorder Yale - Brown Obsessive--Compulsive Scale (BDD - YBOCS). A multiple regression analysis was performed using the BDD - YBOCS score as a continuous dependent variable. The severity of dysmorphic symptoms (BDD - YBOCS score) was significantly related to two factors: the number of diagnostic criteria for schizotypal and paranoid personality disorders. The results suggest that the presence of a psychopathological reaction to imagined defects in appearance in subjects pursuing a surgical correction is associated with the severity of schizotypal and paranoid personality disorders. Preoperative assessment could help to define the clinical profile of patients in cosmetic surgery settings.
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PMID:Dysmorphic concern symptoms and personality disorders: a clinical investigation in patients seeking cosmetic surgery. 1691 6

Good communication is the key to damage limitation. A complaint by a patient should be treated as a medical emergency as early effective communication will almost always neutralise patient anger. Legible and appropriate clinical notes are also important. Patients with depression and dysmorphophobia are potentially litigious, underlying the importance of patient selection.
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PMID:Damage limitation in cosmetic dermatology. 1714 42


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