Cognitive-behavioral treatment of body dysmorphic disorder: a case report

Body dysmorphic disorder (BDD) refers to preoccupation with an imagined physical defect or the exaggeration of a slight physical anomaly. Since BDD's inclusion in the DSM-III-R, there have been only a handful of reports of its cognitive-behavioral treatment. We describe one successful short-term cognitive-behavioral therapy treatment of a BDD patient whose presenting concern was small hand size. After nine sessions of therapy, the patient evidenced substantial change on indices measuring affective, cognitive, and behavioral facets of BDD. There was also clinically meaningful improvement in overall levels of depression and anxiety. It is suggested that cognitive-behavioral treatment programs for BDD should take into account comorbid conditions such as social phobia, and avoidant personality disorder.