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Cognitive–behavioural therapy for body dysmorphic disorder

  • David Veale

The DSM–IV classification of body dysmorphic disorder (BDD) refers to an individual's preoccupation with an ‘imagined’ defect in his or her appearance or markedly excessive concern with a slight physical anomaly (American Psychiatric Association, 1994). An Italian psychiatrist, Morselli, first used the term ‘dysmorphophobia’ in 1886, although it is now falling into disuse, probably because ICD–10 (World Health Organization, 1992) has discarded it, subsuming the condition under hypochondriacal disorder.

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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM–IV). Washington, DC: APA.
Clark, D. M. & Wells, A. (1995) A cognitive model of social phobia. In Social Phobia – Diagnosis, Assessment, and Treatment (eds Heimberg, R. G., Liebowitz, M. R., Hope, D. et al), pp. 6993. Guilford Press: New York.
Clark, D. M., Salkovskis, P. M., Hackmann, A. et al (1998) Two psychological treatments for hypochondriasis. A randomised controlled trial. British Journal of Psychiatry, 173, 218225.
Dryden, W. (1998) Developing Self-Acceptance. Chichester: John Wiley & Sons.
Faravelli, C., Salvatori, S., Galassi, F. et al (1997) Epidemiology of somatoform disorders: a community survey in Florence. Social Psychiatry and Psychiatric Epidemiology, 32, 2429.
Gomez Perez, J. C., Marks, I. M. & Gutierrez Fisac, J. L. (1994) Dysmorphophobia: clinical features and outcome with behavior therapy. European Psychiatry, 9, 229235.
Hollander, E., Allen, A., Kwon, J. et al (1999) Clomipramine vs desipramine crossover trial in body dysmorphic disorder: selective efficacy of a serotonin reuptake inhibitor in imagined ugliness. Archives of General Psychiatry, 56, 10331042.
Lazarus, A. (1977) Towards an ego-less state of being. In Handbook of Rational Emotive Therapy (Vol. 1) (eds Ellis, A. & Grieger, R.) pp. 113118. New York: Springer.
Linehan, M. M. (1993) Skills Training Manual. Guilford Press.
Newell, R. & Shrubb, S. (1994) Attitude change and behaviour therapy in body dysmorphic disorder: two case reports. Behavioural and Cognitive Psychotherapy, 22, 163169.
Neziroglu, F. & Yaryura Tobias, J. A. (1993) Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder. Behavior Therapy, 24, 431438.
Perugi, G., Giannotti, D., Di Vaio, S. et al (1996) Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia). International Clinical Psycho-pharmacology, 11, 247254.
Phillips, K. (1996) The Broken Mirror – Understanding and Treating Body Dysmorphic Disorder. New York: Oxford University Press.
Phillips, K. A. (1998) Body dysmorphic disorder: clinical aspects and treatment strategies. Bulletin of the Menninger Clinic, 62, A33A48.
Phillips, K. A. (2000) Quality of life for patients with body dysmorphic disorder. Journal of Nervous and Mental Disease, 188, 170175.
Phillips, K. A., Dwight, M. M. & McElroy, S. L. (1998) Efficacy and safety of fluvoxamine in body dysmorphic disorder. Journal of Clinical Psychiatry, 59, 165171.
Riding, J. & Munro, A. (1975) Pimozide in the treatment of monosymptomatic hypochondriacal psychosis. Acta Psychiatrica Scandinavica, 53, 2330.
Rosen, J. C., Reiter, J. & Orosan, P. (1995) Cognitive-behavioral body image therapy for body dysmorphic disorder. Journal of Consulting & Clinical Psychology, 63, 263269.
Sarwer, D. B., Wadden, T. A., Pertschuk, M. J. et al (1998) Body image dissatisfaction and body dysmorphic disorder in 100 cosmetic surgery patients. Plastic and Reconstructive Surgery, 101, 16441649.
Treasure, J. L. & Ward, A. (1997) A practical guide to the use of motivational interviewing. European Eating Disorders Review, 5, 102114.
Veale, D. (2000) Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder. Psychiatric Bulletin, 24, 218220.
Veale, D. & Riley, S. (2001) Mirror, mirror on the wall, who is the ugliest of them all? The psychopathogy of mirror gazing in body dysmorphic disorder. Behaviour Research and Therapy (in press).
Veale, D., Gournay, K., Dryden, W. et al (1996a) Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behaviour Research and Therapy, 34, 717729.
Veale, D., Boocock, A., Gournay, K. et al (1996b) Body dysmorphic disorder. A survey of fifty cases. British Journal of Psychiatry, 169, 196201.
Wilhelm, S., Otto, M. W., Lohr, B. et al (1999) Cognitive behavior group therapy for body dysmorphi c disorder: a case series. Behaviour Research and Therapy, 37, 7175.
World Health Organziation (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
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Cognitive–behavioural therapy for body dysmorphic disorder

  • David Veale
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