Optimizing Evidence-Based Treatment for Body Dysmorphic Disorder

This book provides an understanding of body dysmorphic disorder (BDD), a psychiatric issue that is characterized by a  preoccupation with a perceived or slight imperfection in physical appearance and time-consuming compulsions intended to hide, fix, or check appearance concerns. BDD is relatively common, occurring in approximately 2-3% of the population,typically beginning in adolescence. When untreated, BDD is chronic, severe, and associated with substantial psychosocial impairment and morbidity, including unemployment rates of roughly 40-50%, suicide attempts in 22-28%, and lifetime housebound rates of roughly 30%. Cognitive behavioral therapy (CBT) and serotonin reuptake inhibitors are frontline treatments for BDD, shown to be safe and efficacious. However, the vast majority of people with BDD do not receive appropriate care. Many individuals with BDD first seek out non-psychiatric cosmetic treatments, which are ineffective and can be harmful. Moreover, few mental health providers are trained in assessing or treating BDD.  This volume demonstrates how to effectively assess and treat BDD.  It covers the evidence-based means of effectively assessing and treating this disorder,  Both psychological and pharmacological treatments with research support are presented, including randomized controlled trials and meta-analyses of  cognitive behavioral therapy and serotonin reuptake inhibitors for BDD. An important feature is a review of ineffective treatments.. To optimize CBT for BDD, guidelines are provided to  address the most common challenges in diagnosis and treatment including common comorbidities and differential diagnosis with similar disorders.  Case examples throughout illuminate for practitioners the theoretical and clinical aspects of this complex problem.