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Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a mental disorder which involves a disturbed body image. The central feature of BDD is that persons who are afflicted with it are excessively dissatisfied with their body because of a perceived physical defect. An example would be a man who is extremely worried that his nose is too big, although other people don't notice anything unusual about it.

Diagnostic criteria (DSM-IV-TR)

The DSM-IV-TR, the latest version of the diagnostic manual of the American Psychiatric Association (see also: DSM cautionary statement), lists three necessary criteria for a diagnosis of body dysmorphic disorder:

1. Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive.
2. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
3. The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa).

BDD and other disorders

Note that, according to the DSM criteria, a BDD diagnosis cannot be made if another disorder accounts for the preoccupation with a perceived defect. For instance, people who worry excessively about their weight are not considered to have BDD if this preoccupation is accounted for by an eating disorder. Body dysmorphic disorder is also considered to be different from gender identity disorder and transsexualism, even though the desire to modify one's body is also reflected in people who are judged to have these disorders. Some paraphilias also involve a wish to modify one's body. For example, people with apotemnophilia are convinced that a part of their body needs to be amputated.

In the medical community, some make links between BDD and obsessive-compulsive disorder because there are some similarities between these disorders. For instance, obsessive thoughts are a common symptom of both disorders.