Body Dysmorphic Disorder Patients Research Articles

Efficacy of EMDR in Body Dysmorphic Disorder and Associated Cognitive-Emotional Features

Body dysmorphic disorder (BDD) is a severe psychological disorder that significantly impacts functioning and quality of life. Eeye movement desensitization and reprocessing (EMDR) presents as an emerging alternate psychological intervention. This study aimed to examine the efficacy of EMDR in BDD symptoms and associated cognitive-emotional features. These features include appearance-based rejection sensitivity, body shame, and self-compassion. Our study utilized a multiple-baseline across-subjects design, monitoring four randomly allocated female patients with BDD over a 10-session/90-minute EMDR treatment phase and two follow-up sessions at 1 and 3 months, respectively. Our results showed that EMDR significantly reduced BDD symptoms (recovery percentage [RP] = 60.54), appearance-based rejection sensitivity (RP = 36.56), and body shame (RP = 54.82) and increased self-compassion (RP = 51.79). Therefore, our study suggests that EMDR may be an effective treatment for BDD patients.

Learning of the same task subserved by substantially different mechanisms between patients with body dysmorphic disorder and healthy individuals.

It has remained unclear whether individuals with psychiatric disorders involving altered visual processing employ similar neuronal mechanisms during perceptual learning of a visual task. We investigated this question by training patients with body dysmorphic disorder, a psychiatric disorder characterized by distressing or impairing preoccupation with nonexistent or slight defects in one's physical appearance, and healthy controls on a visual detection task for human faces with low spatial frequency components. Brain activation during task performance was measured with functional magnetic resonance imaging before the beginning and after the end of behavioral training. Both groups of participants improved performance on the trained task to a similar extent. However, neuronal changes in the fusiform face area were substantially different between groups such that activation for low spatial frequency faces in the right fusiform face area increased after training in body dysmorphic disorder patients but decreased in controls. Moreover, functional connectivity between left and right fusiform face area decreased after training in patients but increased in controls. Our results indicate that neuronal mechanisms involved in perceptual learning of a face detection task differ fundamentally between body dysmorphic disorder patients and controls. Such different neuronal mechanisms in body dysmorphic disorder patients might reflect the brain's adaptations to altered functions imposed by the psychiatric disorder.

Body dysmorphic disorder symptoms in patients with melasma.

Body dysmorphic disorder (BDD) is a psychiatric condition characterized by extreme preoccupation with non-existent or minor defects in appearance, disrupting daily functioning. Melasma is a common concern among BDD patients with dermatological conditions. This study aimed to estimate the incidence and characteristics of BDD in patients with melasma, and compare the psychological condition of patients and age- and sex-matched healthy controls. Patients with melasma and healthy controls were screened using the BDD Questionnaire (BDDQ), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). A questionnaire was administered to collect demographic information and clinical characteristics. Standard statistical tests were conducted, such as descriptive analysis, chi-square, and nonparametric tests. The level of statistical significance for all tests was set at a P < 0.05. Among the 470 patients with melasma included in the study, 53 were positive for BDDQ in the preliminary screening and were associated with a history of treatment, higher Melasma Area and Severity Index (MASI), and Melasma Quality of Life (MELASQoL) scores, and higher SAS and SDS scores. The positive rate of BDDQ ranged from 0.4%, using the most stringent criteria to assess melasma severity, to 11.3%, without using objective criteria. Compared to healthy controls, patients with melasma had a higher positive rate of BDDQ and higher SAS and SDS scores. In patients with melasma who exaggerate the severity of the disease, psychiatric treatment and the patient-physician relationship have a positive effect. This study assessed the positive rate of BDDQ in melasma and proposed the feasibility of psychiatric treatment for patients with melasma.

The heart of it all: Body dysmorphic disorder in cosmetic surgery

Body Dysmorphic Disorder (BDD) represents a prevalent mental health condition characterized by distress arising from self-perceived physical imperfections. BDD serves as a contraindication to aesthetic surgery. Recognizing BDD holds paramount importance for plastic surgeons, as it is instrumental in averting the exacerbation of this condition while ensuring appropriate referrals. This study aimed to investigate the prevalence of BDD in cosmetic surgery patients and to pinpoint key characteristics associated with BDD. This information provides plastic surgeons with specific factors to consider during preoperative evaluations. We employed TriNetX database to identify patients with BDD who underwent cosmetic surgery identified by Current Procedural Terminology codes. Demographics and patient characteristics were identified using the International Classification of Diseases 10 codes. We calculated odds ratios (OR) by using chi-squared tests to assess risk factors among patients with BDD. Of 226,374 patients who underwent plastic surgery between August 2002 and August 2022, fewer than 0.1% were diagnosed with BDD. Of the BDD patients, 52.1% were diagnosed after cosmetic surgery. Compared with the control group, BDD patients were more likely to undergo rhinoplasty (OR=1.784, p=0.004) and nonlocalized lipectomy (OR=1.448, p=0.021) and less likely to undergo blepharoplasty (OR=0.451, p=0.002). Findings indicated a strong association between BDD patients undergoing cosmetic procedures and comorbid psychiatric conditions such as depression (OR=4.279, p<0.05), anxiety (OR=5.490, p <0.05), and Attention-Deficit Hyperactivity Disorder (OR=3.993, p<0.05). These findings underscore the ongoing significance of BDD in the context of cosmetic surgery, potentially indicating a lower surgery rate among BDD patients compared with previous estimates. Nevertheless, avenues for further improvement persist. Our data affirm the noteworthy occurrence of postsurgery BDD development, thereby highlighting the ongoing necessity for psychiatric evaluation in surgical patients.

Unravelling brain connectivity patterns in body dysmorphic disorder during decision-making on visual illusions: A graph theoretical approach

Body dysmorphic disorder (BDD) is characterized by an excessive preoccupation with perceived defects in physical appearance, and is associated with compulsive checking. Visual illusions are illusory or distorted subjective perceptions of visual stimuli, which are induced by specific visual cues or contexts. While previous research has investigated visual processing in BDD, the decision-making processes involved in visual illusion processing remain unknown. The current study addressed this gap by investigating the brain connectivity patterns of BDD patients during decision-making about visual illusions. Thirty-six adults - 18 BDD (9 female) and 18 healthy controls (10 female) - viewed 39 visual illusions while their EEG was recorded. For each image, participants were asked to indicate (1) whether they perceived the illusory features of the images; and (2) their degree of confidence in their response. Our results did not uncover group-level differences in susceptibility to visual illusions, supporting the idea that higher-order differences, as opposed to lower-level visual impairments, can account for the visual processing differences that have previously been reported in BDD. However, the BDD group had lower confidence ratings when they reported illusory percepts, reflecting increased feelings of doubt. At the neural level, individuals with BDD showed greater theta band connectivity while making decisions about the visual illusions, likely reflecting higher intolerance to uncertainty and thus increased performance monitoring. Finally, control participants showed increased left-to-right and front-to-back directed connectivity in the alpha band, which may suggest more efficient top-down modulation of sensory areas in control participants compared to individuals with BDD. Overall, our findings are consistent with the idea that higher-order disruptions in BDD are associated with increased performance monitoring during decision-making, which may be related to constant mental rechecking of responses.

A randomized controlled trial of mindfulness-based cognitive therapy for body dysmorphic disorder: Impact on core symptoms, emotion dysregulation, and executive functioning

Background and objectivesMindfulness-based cognitive therapy (MBCT) is garnering increasing empirical interest as an intervention for Body Dysmorphic Disorder (BDD), although no studies of mindfulness as a standalone treatment have included a sample composed entirely of patients with BDD or a comparison group. The aim of this study was to investigate the improvement of MBCT intervention on the core symptoms, emotional dysfunction, and executive function of BDD patients, as well as the feasibility and acceptability of MBCT training. MethodPatients with BDD were randomized into an 8-week MBCT group (n = 58) or treatment-as-usual (TAU) control group (n = 58) and were assessed at pre-treatment, post-treatment, and 3-month follow-up. ResultsParticipants who received MBCT showed greater improvement on self-reported and clinician ratings of BDD symptoms, self-reported emotion dysregulation symptoms and executive function compared with TAU participants. Improvement for executive function tasks was partially supported. In addition, feasibility and acceptability of MBCT training were positive. LimitationsThere is no systematic assessment of the severity of key potential outcome variables associated with BDD. ConclusionMBCT may be a useful intervention for patients with BDD, improving patients’ BDD symptoms, emotion dysregulation, and executive functioning.

Untargeted metabolomic analysis of metabolites related to body dysmorphic disorder (BDD)

Body dysmorphic disorder (BDD) is a disorder associated with depression and eating disorders. It often arises from minor defects in appearance or an individual imagining that he or she is defective. However, the mechanisms causing BDD remain unclear, and its pathogenesis and adjuvant treatment methods still need to be explored. Here, we employed a liquid chromatography-mass spectrometry (LC–MS)-based metabolomics approach to identify key metabolic differences in BDD versus healthy patients. We obtained plasma samples from two independent cohorts (including eight BDD patients and eight healthy control patients). Raw data were analyzed using Compound Discoverer to determine peak alignment, retention time correction, and extraction of peak areas. Metabolite structure identification was also obtained using Compound Discoverer by of accurate mass matching (< 10 ppm) and secondary spectral matching queries of compound databases. Next, multidimensional statistical analyses were performed using the ropls R package. These analyses included: unsupervised principal component analysis, supervised partial Least-Squares Discriminant Analysis, and orthogonal partial Least-Squares Discriminant Analysis. We then identified the most promising metabolic signatures associated with BDD across all metabolomic datasets. Principal component analysis showed changes in small-molecule metabolites in patients, and we also found significant differences in metabolite abundance between the BDD and normal groups. Our findings suggest that the occurrence of BDD may be related to metabolites participating in the following KEGG pathways: ABC transporters, purine metabolism, glycine, serine and threonine metabolism, pyrimidine, pyrimidine metabolism, biosynthesis of 12-, 14-, and 16-membered macrolides, microbial metabolism in diverse environments, biosynthesis of secondary metabolites, and caffeine and insect hormone biosynthesis.

Psychology of aesthetics: Beauty, social media, and body dysmorphic disorder.

The perception of beauty is fluid within society and can morph based on cultural practices and societal interaction, such as social media exposure. The exposure to digital conference platforms has increased significantly, leading users to check their appearance constantly and find flaws in their perceived virtual appearance. Studies have shown that frequent social media use may lead to unrealistic body image ideals, a significant concern with appearance, and anxiety. Also, social media exposure can worsen body image dissatisfaction, social networking site addiction, and comorbidities of body dysmorphic disorder (BDD) such as depression and eating disorders. Additionally, excessive social media use can increase preoccupation with imagined image defects among BDD patients leading them to pursue minimally invasive cosmetic and plastic surgery procedures. This contribution aims to provide an overview of the evidence surrounding the perception of beauty, cultural aspects of aesthetics, and social media's consequences, especially on BDD's clinical specifics.

Efficacy of Cognitive Therapy for Body Dysmorphic Disorder: A Randomized Controlled Pilot Trial

Dysfunctional cognitive processes and maladaptive interpersonal patterns have been postulated to maintain body dysmorphic disorder (BDD). The present trial evaluated CT for BDD (CT-BDD), which includes modules targeting maladaptive cognitive processing in BDD, as well as elements of schema therapy related to interpersonal problems. We investigated whether (a) CT-BDD is effective, as compared with a wait-list (WL) group at Week 12; (b) outcome of CT-BDD is maintained at posttreatment and 3- and 6-months follow-up; and (c) whether changes in shame and insight mediate changes in BDD symptom severity. Forty adults with BDD were randomized to 36 weeks immediate CT-BDD (n = 21), or to 12-week WL (n = 19). At Week 12, immediate CT-BDD was significantly superior to WL in clinician-rated BDD symptom severity, insight, self-reported BDD symptoms, shame, depression, general symptomatology, and life satisfaction. Changes in outcomes were associated with moderate to large effect sizes at Week 12. Reductions in shame and increase in insight separately mediated changes in BDD symptom severity during treatment at Week 12. From baseline to posttreatment, significant improvements occurred within CT-BDD in clinician-rated symptom severity, insight, depression, global functioning, self-reported BDD symptoms, shame, depression, general symptomatology, and life satisfaction. At posttreatment, improvements were associated with large effect sizes and were maintained at 3- and 6-month follow-up. Preliminary results support the efficacy of CT-BDD. Addressing interpersonal problems in addition to cognitive dysfunctions may increase the benefit of CBT for BDD patients.

Deciding on Optical Illusions: Reduced Alpha Power in Body Dysmorphic Disorder.

Background: Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by excessive preoccupation with imagined defects in appearance. Optical illusions induce illusory effects that distort the presented stimulus, thus leading to ambiguous percepts. Using electroencephalography (EEG), we investigated whether BDD is related to differentiated perception during illusory percepts. Methods: A total of 18 BDD patients and 18 controls were presented with 39 optical illusions together with a statement testing whether or not they perceived the illusion. After a delay period, they were prompted to answer whether the statement was right/wrong and their degree of confidence in their answer. We investigated differences of BDD patients on task performance and self-reported confidence and analyzed the brain oscillations during decision-making using nonparametric cluster statistics. Results: Behaviorally, the BDD group exhibited reduced confidence when responding incorrectly, potentially attributed to higher levels of doubt. Electrophysiologically, the BDD group showed significantly reduced alpha power at the fronto-central and parietal scalp areas, suggesting impaired allocation of attention. Interestingly, the lower the alpha power of the identified cluster, the higher the BDD severity, as assessed by BDD psychometrics. Conclusions: Results evidenced that alpha power during illusory processing might serve as a quantitative EEG biomarker of BDD, potentially associated with reduced inhibition of task-irrelevant areas.

Substantial changes in global brain processing related to face perception in body dysmorphic disorder patients by training on low spatial frequency components in faces

Substantial changes in global brain processing related to face perception in body dysmorphic disorder patients by training on low spatial frequency components in faces

BDD Knowledge, Attitude and Practice Among Aesthetic Plastic Surgeons Worldwide.

Body dysmorphic disorder (BDD) is a controversial topic in the field of plastic surgery. Our aim was to determine whether BDD knowledge, attitude and practice (KAP) are affected by the experience of the surgeon in the field, sex of the surgeon, country of practice, and the number of patients the surgeon sees annually. We were particularly interested in uncovering any significant relations in KAP of BDD between plastic surgeons practicing in developed versus developing countries. We created a two-page survey of 24 questions about the KAP of BDD. The survey was sent to aesthetic plastic surgeons worldwide via ISAPS global email list. The data were collected over a period of 20 days at the end of 2020. A total of 464 plastic surgeons completed the survey. The only factor that determines the awareness of BDD is the experience of the surgeon. The more experienced the surgeon is, the more likely he/she is to be familiar with the clinical picture of BDD. Although aware, the more experienced surgeons tend to dismiss the importance of referring BDD patients to psychiatrists/psychologists. Male surgeons tend to diagnose more patients with BDD than female surgeons. Surgeons who estimated the correct prevalence of BDD among patients seeking surgery acquired knowledge of BDD from scientific journals. The KAP is relatively similar between surgeons practicing in developed and developing countries, and the main statistically significant difference was in the questions used during the course of the interviews to diagnose BDD. We can deduce from the results that most aesthetic surgeons worldwide have got knowledge of the presentation of BDD and are keen to diagnose the disorder in their practice. It is worth noting that surgeons usually have their unique approach in the management of BDD. Our study highlights the importance of not only raising awareness of the best management of BDD, but also of establishing a consensus that BDD is a contraindication to aesthetic treatment. The best methods to raise awareness are through journals and plastic surgery residency. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

Early auditory-evoked potentials in body dysmorphic disorder: An ERP/sLORETA study

Body dysmorphic disorder (BDD) is characterized by excessive preoccupation with imagined or slight physical defects in appearance. BDD is associated with cognitive impairments (attention, visual processing). Our study aims to evaluate the early neural responses (N100, P200) to prepulse inhibition (PPI) and prepulse facilitation (PPF), to investigate attentional processing of BDD in the auditory domain. Fifty-five adults took part: 30 BDD patients and 25 healthy controls. We compared their brain responses to PPI and PPF by analyzing global field power (GFP), event-related potentials (ERPs) and their respective sources. BDD exhibited reduced N100 amplitudes compared to healthy controls in response to the startle tone elicited by both PPI and PPF, potentially suggesting impaired allocation of attention. Interestingly, the lower the GFP at the N100, the higher the BDD severity. Source reconstruction analysis showed reduced activation for BDD during the N100 time window in PPI. Scalp responses and source activations in PPI were decreased overall compared to PPF, confirming the gating effect of PPI. We provided evidence that the N100 may serve as an electrophysiological marker of BDD, predicting its severity. Our study demonstrated the potential of using ERPs combined with behavioural PPI and PPF protocols to advance our understanding of BDD pathophysiology.

Empirical evidence for cognitive subgroups in body dysmorphic disorder.

Current understanding of cognitive functioning in body dysmorphic disorder is limited, owing to few studies, small sample sizes and assessment across only limited cognitive domains. Existing research has also shown inconsistent findings, with both intact and impaired cognition reported in body dysmorphic disorder, which might point towards cognitive heterogeneity in the disorder. This study aimed to examine the cognitive profile of body dysmorphic disorder in a large sample across eight cognitive domains, and to explore whether cognitive subgroups might be identified within body dysmorphic disorder. Cognitive domains of inhibition/flexibility, working memory, speed of processing, reasoning and problem-solving, visual and verbal learning, attention/vigilance and social cognition were assessed and compared between 65 body dysmorphic disorder patients and 70 healthy controls. Then, hierarchical clustering analysis was conducted on the body dysmorphic disorder group's cognitive data. Group-average comparisons demonstrated significantly poorer cognitive functioning in body dysmorphic disorder than healthy controls in all domains except for attention/vigilance and social cognition. Cluster analysis identified two divergent cognitive subgroups within our body dysmorphic disorder cohort characterised by (1) broadly intact cognitive function with mild selective impairments (72.3%), and (2) broadly impaired cognitive function (27.7%). However, the clusters did not significantly differ on clinical parameters or most sociodemographic characteristics. Our findings demonstrate considerable cognitive heterogeneity among persons with body dysmorphic disorder, rather than uniform deficits. Poor performances in the broadly impaired subgroup may have driven group-level differences. However, our findings also suggest a dissociation between cognitive functioning and clinical characteristics in body dysmorphic disorder that has implications for current aetiological models. Additional research is needed to clarify why some people with body dysmorphic disorder demonstrate cognitive deficits while others do not.

Body dysmorphic disorder in patients with telangiectasias.

Chronic venous disease (CVD) patients can present with a spectrum of clinical manifestations ranging from severe ulcerations, thrombosis, and varicose vein hemorrhage to milder ones such as telangiectasias. Some CVD patients have a minimal degree of telangiectasias that are almost invisible to the physician. In spite of successful treatment of these telangiectasias, there are patients that might insist on continuing treatment, focusing excessive attention on what they perceive to be persistent telangiectasias that, in their opinion, must be removed. In these cases, one might be facing a possible body dysmorphic disorder (BDD) diagnosis. This is a multicentric study performed in 223 patients with telangiectasias (C1s) seeking treatment; the Body Dysmorphic Disorder Questionnaire (BDDQ) was answered in private by all the patients. Furthermore, each questionnaire was evaluated in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for BDD. From a consecutive sample of 223 patients, 38 patients had criteria for BDD according to the DSM-V; indicating that the prevalence of BDD in patients with telangiectasias is 17%. Telangiectasias can be a stress trigger that changes the way patients perceive their own appearance. BDD patients tend to focus their attention excessively upon these types of veins and demand unnecessary treatment for minimal telangiectasias in order to diminish their discomfort with their physical appearance. Body dysmorphic disorder occurs in patients with limbs with C1s disease in considerable proportion and, upon evaluation, these patients should be referred to a psychiatrist. The initiation of any treatment for telangiectasias prior to the psychiatric assessment should be avoided.

Bell’s Palsy Development in Patients Using Quetiapine Adjunct to Sertraline: A Case Study

Introduction: Bell`s palsy is a neurological condition manifests with acute unilateral neuropathy of 7th cranial nerve. The cause is not clear. However, some infections, immune system responses and ischemic causes are suggested as etiologies. We report 2 cases with Bell`s palsy while using quetiapine plus sertraline, in the absence of concurrent prescriptions which have been reported Bell’s palsy as an adverse effect.&#x0D; Cases Presentation: First patient was an Iranian 54 years old male with Major Depressive Disorder who has been treated by sertraline 100mg per day for 1 year. His main manifestations was depressed mood, fatigue, insomnia, irritability, suicidal ideas and social isolation. He presented the classical manifestations of peripheral Bell`s palsy only 3 days after initiation of quetiapine 50mg per night. Brain imaging such as Magnetic Resonance Imaging (MRI) and Diffusion Weighted Imaging (DWI) was performed. Also other investigations for infective and immune causes were done. All of them showed normal results. The second case was an Iranian 20 year old female diagnosed as Major Depressive and Body dysmorphic disorder patient. She was being treated by sertraline 100 mg/daily plus quetiapine 25md per night for 15 months. She also presented peripheral type of Bell`s palsy while using this combination therapy. Neurological investigations also performed and all results were normal. She recovered after reduction of quetiapine dosage to 12.5 mg per night and prescription of acyclovir and dexamethasone by our neurologist colleague.&#x0D; Discussion: Based on our search there is no reported correlation between psychiatric medications and Bell`s palsy. First explanation about our cases is an accidental correlation but also the short time correlation between initiation of treatment and presenting Bell’s palsy in first case and recovery of second one after reduction of quetiapine dosage are supporting the idea that the combination of sertraline and quetiapine may causes Bell’s palsy. Some articles have mentioned that antipsychotic drugs may have a weak antibiotic agent role and specially may demonstrate an inhibitory effect on neurotropic viruses, such as herpes simplex. Sertraline may also acts as an antibacterial agent. Reduction of protecting human microbiota may explain our observations.&#x0D; Conclusion: Combination of sertraline and quetiapine may cause Bell`s palsy and clinicians should consider neurological adverse effects of this common combination

Body Dysmorphic Disorder in Dermatology: a Systematic Review

Body Dysmorphic Disorder (BDD) is a psychiatric diagnosis of an impairing condition in which the patient is preoccupied with a slight or perceived defect in their appearance. BDD patients have a higher rate of psychiatric comorbidities than the background population which include obsessive-compulsive disorder (OCD), depression, anxiety and suicide. It causes distress and affects the patient's quality of life. It is previously found that the prevalence of patients that suffers from BDD is higher among dermatology patients than in the background population. To create an overview of the original literature that exist on topic: BDD in dermatology. A systematic review was conducted by two reviewers. PubMed was searched using a predefined search string created in collaboration between the authors and a bibliographic fellow on 18th of August 2018 and again in January 2020. 45 articles were obtained and after exclusion 5 relevant articles remained. Dermatology patients have a higher incidence of BDD than the background population. BDD patients are significantly younger and it has been suggested that BDD develops during adolescence but is diagnosed with a delay of several years because patients seek out health care professionals among non-mental health specialists. BDD does not appear associated with the setting, i.e. cosmetic vs general dermatology, but BDD patients have a lower quality of life and are more commonly unemployed or on sick leave. It is often difficult to treat, and a combination of the dermatologic treatment and the psychiatric treatment may be necessary in the context of visible skin pathology.

Examining memory performance in body dysmorphic disorder (BDD): A comparison study with obsessive compulsive disorder (OCD)

The aim of this study is comparing directly the BDD and OCD disorders in terms of similarities and differences in memory function for the first time. 19 BDD patients, 15 OCD patients and 26 individuals in a healthy control group were recruited from three hospitals in Tehran. They were administered the following subtests of the Wechsler Memory Scale: logical memory (immediate and delayed), verbal paired association (immediate and delayed), digit span and spatial span as well as the Rey-Osterrieth complex figure test (RCFT). The results showed that BDD and OCD groups had lower performance in comparison to the control group across all measures, except for the immediate memory of the verbal paired associate task, which was similar across the three groups. Both the BDD and OCD groups showed poor performance on the auditory-verbal memory tasks. However, only the BDD group showed poor performance in the visual domain (i.e. spatial span and RCFT). This suggest that memory deficits are similar between BDD and OCD patients in the verbal domain. Furthermore, BDD patients demonstrated poorer visual working memory. The findings of this study reveal that BDD and OCD patients have more similarities than differences regarding neuropsychological features, in other words, the idea of the incorporation of BDD within the obsessive-compulsive and related disorders (OCRDs) spectrum in DSM-5 is supported, at least through the viewpoint of neuropsychology.

Neural Correlates of Own- and Other-Face Perception in Body Dysmorphic Disorder.

BackgroundBody dysmorphic disorder (BDD) is characterized by an excessive preoccupation with one or more perceived flaws in one’s own appearance. Previous studies provided evidence for deficits in configural and holistic processing in BDD. Preliminary evidence suggests abnormalities at an early stage of visual processing. The present study is the first examining early neurocognitive perception of the own face in BDD by using electroencephalography (EEG). We investigated the face inversion effect, in which inverted (upside-down) faces are disproportionately poorly processed compared to upright faces. This effect reflects a disruption of configural and holistic processing, and in consequence a preponderance of featural face processing.MethodsWe recorded face-sensitive event-related potentials (ERPs) in 16 BDD patients and 16 healthy controls, all unmedicated. Participants viewed upright and inverted (upside-down) images of their own face and an unfamiliar other face, each in two facial emotional expressions (neutral vs. smiling). We calculated the early ERP components P100, N170, P200, N250, and the late positive component (LPC), and compared amplitudes among both groups.ResultsIn the early P100, no face inversion effects were found in both groups. In the N170, both groups exhibited the common face inversion effects, with significantly larger N170 amplitudes for inverted than upright faces. In the P200, both groups exhibited larger inversion effects to other (relative to own) faces, with larger P200 amplitudes for other upright than inverted faces. In the N250, no significant group differences were found in face processing. In the LPC, both groups exhibited larger inversion effects to other (relative to own) faces, with larger LPC amplitudes for other inverted than upright faces. These overall patterns appeared to be comparable for both groups. Smaller inversion effects to own (relative to other) faces were observed in none of these components in BDD, relative to controls.ConclusionsThe findings suggest no evidence for abnormalities at all levels of early face processing in our observed sample of BDD patients. Further research should investigate the neural substrates underlying BDD symptomatology.

Awareness and experiences of cosmetic treatment providers with body dysmorphic disorder in Saudi Arabia.

Body Dysmorphic Disorder (BDD) is defined as a constant obsession with one’s external appearance and flaws, and it falls under the criteria of neuropsychiatric disorders. Individuals suffering from this disorder may seek unnecessary cosmetic procedures from cosmetic treatment providers such as dermatologists or plastic surgeons. Cosmetic treatments have become readily available, which has led to an influx of undiagnosed BDD patients electing to undergo such treatments. Therefore, physicians should have the clinical knowledge about BDD to diagnose and manage these cases to avoid psychological and physical harm to these patients. However, there were no studies conducted in our region to assess the awareness of BDD among physicians who provide cosmetic treatments with regards to their attitude toward such cases and how they would manage it. This study aims to assess the awareness of Body Dysmorphic Disorder among Saudi physicians who provide cosmetic treatments. We conducted an observational cross-sectional study among physicians practicing in hospitals and cosmetic clinics in Riyadh and Jeddah city (Saudi Arabia), who perform cosmetic procedures, namely dermatologists, plastic surgeons, and otorhinolaryngologists. A paper-based questionnaire consisting of multiple-choice questions was distributed among them. The total number of participants was 155 physicians: 113 (72.9%) males and 42 (27.1%) females. Eighty-two (52.9%) participants reported that they have been familiar with the diagnostic criteria of BDD for a long time and ninety-nine (63.8%) reported being familiar with the clinical picture of BDD. Sixty-three (40.6%) participants estimated the prevalence of BDD cases seen in cosmetic practice to range from 1%-5%, and most agreed on an equal prevalence of BDD among female and male patients. Half of the participants (n = 76) (49%) reported that they sometimes share knowledge about BDD with patients whom they suspect to suffer from this condition. In conclusion, cosmetic treatment providers in Saudi Arabia are aware of BDD, but we have identified a discrepancy between the self-reported participant knowledge of diagnostic criteria and their ability to accurately estimate the prevalence of BDD cases seen in clinical practice.