Body dysmorphic disorder: A diagnostic challenge in adolescence

Area of Science:

• Psychiatry
• Clinical Psychology
• Developmental Psychology

Background:

• Body dysmorphic disorder (BDD) is a chronic mental health condition characterized by obsessive preoccupation with perceived physical flaws.
• BDD is classified within the obsessive-compulsive spectrum and often co-occurs with depression and significant quality of life impairment.
• The disorder typically emerges in childhood or adolescence, with sub-clinical symptoms often preceding full diagnostic criteria.

Observation:

• A case is presented of an adolescent admitted to an inpatient psychiatric unit for treatment-resistant psychotic symptoms.
• The adolescent's presentation was complicated by underlying Body Dysmorphic Disorder (BDD).
• This case underscores the diagnostic complexities and potential for misdiagnosis in adolescents with severe BDD.

Findings:

• The adolescent's psychotic symptoms were poorly responsive to conventional psychiatric treatments.
• The underlying BDD contributed significantly to the diagnostic challenge and treatment resistance.
• Comorbidities associated with BDD were evident, complicating the clinical picture.

Implications:

• Early and accurate diagnosis of BDD in adolescents is crucial for effective treatment.
• Recognizing BDD as a potential underlying factor in treatment-resistant psychiatric symptoms is important.
• This case highlights the need for comprehensive assessment in adolescent psychiatric care to address complex presentations of BDD.