eMedicine Specialties > Psychiatry > Psychosomatic

Body Dysmorphic Disorder: Differential Diagnoses & Workup

Author: Gary K Arthur, MD, Clinical Assistant Professor, Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine
Coauthor(s): Kim Monnell, DO, Consulting Staff, Department of Neurology, Sarasota Memorial Hospital
Contributor Information and Disclosures

Updated: Aug 20, 2007

Differential Diagnoses

Anorexia Nervosa
Conversion Disorders
Delusional Disorder
Major Depression
Obsessive-Compulsive Disorder
Social Phobia

Other Problems to Be Considered

Normal concerns about appearance
Major depressive disorder
Avoidant personality disorder
Narcissistic personality disorder
Sexual identity disorder

Workup

Other Tests

  • The Multidimensional Body-Self Relations Questionnaire is a self-reported measure of body image. It assesses satisfaction with appearance and preoccupation with perceived defects. This is used in clinical trails and may not be practical in routine office settings.
  • The Body Dysmorphic Disorder Examination Self-Report measures the dissatisfaction the patient has related to the perceived defect. This is another tool used in clinical trials and may not be practical in routine office settings.
  • Mental Status Examination
    • In the typical mental status, the nondelusional patient displays little or no insight. For a brief time they may admit that they might be wrong about their preoccupation. They have often only come to the psychiatrist because they were coerced by a family member or because it was ordered by the plastic surgeon.
    • A delusion is a false belief that a person cannot be talked out of, even with adequate proof. The delusional patient with BDD may believe that what they believe as their abnormal body part is slowly worsening or that other people are always staring or know about it.
    • The remainder of the mental status examination is usually within normal limits except for the amount of time and energy spent on the preoccupation. Auditory hallucinations or wide mood swings might point to additional diagnoses such as schizophrenia or bipolar disorder.

More on Body Dysmorphic Disorder

Overview: Body Dysmorphic Disorder
Differential Diagnoses & Workup: Body Dysmorphic Disorder
Treatment & Medication: Body Dysmorphic Disorder
Follow-up: Body Dysmorphic Disorder
References
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References

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Further Reading

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Keywords

BDD, somatoform disorder, imagined defect of the body, low self-esteem, obsessive-compulsive disorder, OCD, major depression, delusion, social phobia, social anxiety disorder, SAD

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Contributor Information and Disclosures

Author

Gary K Arthur, MD, Clinical Assistant Professor, Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine
Gary K Arthur, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Nothing to disclose.

Coauthor(s)

Kim Monnell, DO, Consulting Staff, Department of Neurology, Sarasota Memorial Hospital
Kim Monnell, DO is a member of the following medical societies: American Academy of Neurology and American Osteopathic Association
Disclosure: Nothing to disclose.

Medical Editor

Denis F Darko, MD, Director, Central Nervous System Clinical Research, Clinical Science, Green Hospital
Denis F Darko, MD is a member of the following medical societies: American Academy of Sleep Medicine, American College of Physicians, American Medical Association, American Psychiatric Association, American Psychosomatic Society, and Endocrine Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David Bienenfeld, MD, Vice-Chair, Program Director, Professor, Department of Psychiatry, Wright State University School of Medicine
David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; BMS Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Other; Northstar Grant/research funds Other; Novartis  Other

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration
Disclosure: Nothing to disclose.

 
 
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