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Dysmorphophobic disorder: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Body dysmorphic disorder is characterized by a preoccupation with imagined or minor defects in appearance that causes significant distress or interferes with social, occupational, or other functioning. Diagnosis is based on history. Treatment consists of medication and psychotherapy.
Body dysmorphic disorder usually begins in adolescence and occurs equally in men and women.
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Symptoms of Body Dysmorphic Disorder
Symptoms may develop gradually or suddenly. Symptoms may vary in severity. Symptoms usually affect the face or head, but may involve other parts of the body or several parts, and may shift from one part of the body to another. The patient may be concerned about thinning hair, acne, wrinkles, scars, spider veins, complexion, excessive facial hair, or may focus on the shape or size of the nose, eyes, ears, mouth, breasts, buttocks, or other body parts. Men may have a form of the disorder called muscle dysmorphic disorder, which involves a preoccupation with the idea that their body is not lean and muscular enough.
Patients typically spend many hours a day ruminating about the perceived defect. Most constantly examine themselves in the mirror, others avoid the mirror, and others alternate between the two. Most try to hide their perceived defect, such as by growing a beard to hide scars or wearing a hat to cover slightly thinning hair. Many undergo medical, dental, or surgical treatment to correct the perceived defect, but these treatments do not produce the desired results and may increase their preoccupation. Men with muscle dysmorphic disorder may use androgen supplements.
Many patients avoid public appearances. Some leave their homes only at night; others do not leave their homes at all. As a result, social isolation, repeated hospitalizations, and suicidal behavior are observed.
Diagnosis and treatment of body dysmorphic disorder
Because patients with this disorder are reluctant to disclose their symptoms, the disorder may remain undiagnosed for years. It differs from normal concerns about one's appearance because it is time-consuming, causes significant distress, and impairs functioning.
The diagnosis is based on the patient's history. If there is concern only with body shape and weight, anorexia nervosa is probably a more accurate diagnosis; if the concern is only with sexual characteristics, gender identity disorder is likely.
SSRIs are often effective, although fairly high doses are usually recommended. Cognitive behavioral therapy is also effective.