Body dysmorphic disorder.

BACKGROUND: Body dysmorphic disorder (BDD) is a syndrome characterized by distress secondary to imagined or minor defects in one's appearance. Although it is a psychiatric disorder, most affected patients present to the dermatologist or plastic surgeon to improve their perceived defect.

OBJECTIVE: The objective was to review the literature on BDD, examining the epidemiology, etiology, clinical features, diagnostic criteria, and treatment of the disorder.

METHODS: Three representative cases of BDD are presented; in addition, a search of MEDLINE was completed and a review of all published data on BDD was performed.

RESULTS: BDD has an estimated prevalence of 1 to 2% in the general population; this prevalence is increased in patient populations. There is significant comorbidity associated with BDD.

CONCLUSIONS: BDD is a relatively common psychiatric disorder in which patients typically present to cosmetic surgeons for treatment of their perceived or imagined defect. Surgical treatments usually prove unsatisfactory to the patient and to the practitioner. Psychiatric treatment is extremely challenging.