CME Body Dysmorphic Disorder and Cosmetic Surgery

Philadelphia, Pa. Learning Objectives: After studying this article, the participant should be able to: 1. Identify the diagnostic criteria and clinical features of body dysmorphic disorder. 2. Describe the prevalence of body dysmorphic disorder in cosmetic populations. 3. Identify appropriate treatment strategies for body dysmorphic disorder. Background: Body dysmorphic disorder is a relatively common psychiatric disorder among persons who seek cosmetic surgical and minimally invasive treatments. Methods: This article reviews the history of the diagnosis and the current diagnostic criteria. Etiologic theories, clinical and demographic characteristics, and comorbidity, including the relationship of body dysmorphic disorder to obsessive-compulsive spectrum and impulse control disorders, are discussed. The prevalence of body dysmorphic disorder in cosmetic populations is highlighted. Treatments for body dysmorphic disorder, including medical, psychiatric, and psychological interventions, are reviewed. Results: Body dysmorphic disorder is an often severe, impairing disorder. Among patients presenting for cosmetic treatments, 7 to 15 percent may suffer from the condition. Retrospective outcome studies suggest that persons with body dysmorphic disorder typically do not benefit from cosmetic procedures. Pharmacotherapy and cognitive-behavioral psychotherapy, in contrast, appear to be effective treatments for body dysmorphic disorder. Conclusions: Because of the frequency with which persons with body dysmorphic disorder pursue cosmetic procedures, providers of cosmetic surgical and minimally invasive treatments may be able to identify and refer these patients for appropriate mental health care. Directions for future research are suggested. (Plast. Reconstr. Surg. 118: 167e, 2006.)