Body dysmorphic disorder--a fear of imagined ugliness.

BACKGROUND: Body dysmorphic disorder (BDD) is a distressing and impairing illness characterised by an intense time consuming preoccupation with an imagined or slight defect in appearance of a body part or parts.

OBJECTIVE: This article outlines the characteristic features and treatment approaches for BDD and suggests screening techniques that can be usefully applied in the general practice setting.

DISCUSSION: Body dysmorphic disorder has been shown to be common and chronic yet goes under recognised as the patient is often secretive about their distress. In an endeavour to alleviate the distress, time consuming rituals are performed that are either without effect or paradoxically may exacerbate the distress. Recent treatment studies show that the selective serotonin reuptake inhibitors and cognitive behavioural therapy, used simultaneously or alone, can be beneficial in alleviating the distress and impairment associated with the condition.