A review of cognitive behavioral and pharmacological treatment of body dysmorphic disorder

Body dysmorphic disorder (BDD) first appeared in the diagnostic nomenclature in 1987 with the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised (DSM-III-R) (APA, 1987). Currently in DSM-IV (APA, 1994), the criterion of impairment in functioning was added to the already existing criteria of preoccupation with an imagined defect in appearance not accounted for by another mental disorder. The body parts most often perceived as defective are the nose, hair, and complexion. Behavioral and pharmacological studies consist primarily of case reports. Systematic desensitization, exposure and response prevention, and cognitive therapy are promising approaches that need further investigation. Pharmacological agents noted to be beneficial are the selective serotonin reuptake inhibitors. Controlled studies in this area are also needed.