F45.2 BODY DISMORPHIC DISORDER
 
General Description
The essential feature is a persistent preoccupation with the possibility of having one or more serious and progressive physical disorders. Patients manifest persistent somatic complaints or a persistent preoccupation with their physical appearance. Normal or commonplace sensations and appearances are often interpreted by patients as abnormal and distressing, and attention is usually focused upon only one or two organs or systems of the body. Marked depression and anxiety are often present, and may justify additional diagnoses.


  FURTHER INFORMATION
People with Body Dysmorphic Disorder are ashamed of their "defect" and invent elaborate means to hide their deformity from the world. Camouflaging behaviors include excessive hair combing and hair removal, ritualized application of makeup and avoidance of situations that might expose the perceived defect. Anxiety, shame and secondary depression are frequent consequences of this disorder. In one case series of individuals with BDD, 30% were so impaired as to remain housebound.
 
Examples
The defining features of Body Dysmorphic Disorder are a distressing and time-consuming preoccupation with an imaginary defect in one's appearance, or excessive concern about a slight physical anomaly. This preoccupation causes significant distress or impairs school or work, personal or social functioning. Although virtually any body part can become the source of preoccupation, BDD most commonly involves the eyes, ears, nose, skin, chin, jaw or other facial features. Other areas of concern include hands, feet, breasts and genitals.

       
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