Body Dysmorphic Disorder (BDD)

Preoccupation with perceived physical defects, not observable to others, leading to repetitive behaviors and distress.

Etiology (Biopsychosocial Model)

Biological: Serotonin imbalance, visual processing deficits.

Psychological: Perfectionism, shame, appearance-based self-worth.

Social: Perfectionism, shame, appearance-based self-worth.

Symptoms & Diagnosis (Mnemonic: MIRROR):

M - Mental acts (comparison, reassurance)

I - Impairment in functioning

R - Repetitive behaviors (grooming, checking)

R - Rules out eating disorder if weight is concern

O - Obsessive preoccupation

R - Obsessive preoccupation

Treatment

CBT with mirror exposure and perceptual retraining

SSRIs for obsessive symptoms

Avoid cosmetic procedures; they rarely help

Info

DSM-5-TR Code

F45.22

Prevalence

~2.4% in adults; muscle dysmorphia more common in males.