Atopic Dermatitis: a Short Summary
Body Dysmorphic Disorder (BDD) (For Professionals)
- frequency: it is common being present in:
- 11.9% of people in dermatology offices
- 8-15% of people in a cosmetic setting
- 1-2% of individuals in the population
- Cases which can resemble Body Dysmorphoc Disorder (BDD):
- Stigmatization feelings in objective dematological (skin) disorders
- BDD behaviour in eating disorders (eg anorexia)
- BDD aspects in somatization disorders (eg somatoform hair loss)
- Personality profiles of patients with BDD
- Paranoid type: Focused on symptoms. Has no doubts about being disfigured.
- Narcistic type: High level of attractiveness. Body surface always visible. Narcisstic behaviour
- Social phobic type: Social phobia evident, Doesn’t require contact with other individuals, Isolation (Social withdrawal)
- Obsessive type: Obsessive behaviour. Mirror checking behaviour evident. Anxiety
- Schizoid type: Schizoid isolation. Resistance to empathy. Difficulty in interaction (socially distant)
- Posttraumatic type: Traumatic events in early childhood or puberty. Onset after life events.
- For patients with BDD, Depression versus non depression is 4 times more likely in dermatology and cosmetic patients. In plastic surgery, the odds are three times more likely.
- Symptoms of BDD
- Mirror checking
- Avoidance behaviour
- Skin picking
- Low self esteem
- Dermatological/ plastic surgery treatment seeking
- Camouflaging
- Life style drugs
- Social Phobia
- Suicidal Ideation
- What patients say that should raise suspicion that the patient could have BDD:
- “I cannot live with those symptoms”
- “I cannot present myself to others”
- “If the skin problem wasn’t there, I am quite normal and have no psychological problems”
- “My partner will not accept my symptoms”
- “Is there a cosmetic or surgical treatment ?”
- “Other people are looking at my skin symptoms”
- Treatments are aimed at treating the symptoms af the perceived skin disorder:
- If there is no influence on normal life function: treat the skin
- Shame stigmatization: relaxation, communication skills training, psychotherapy
- Depression: relaxation, communication skills training, psychotherapy, antidepressants
- Somatization…
Contributors:
Dr Christophe HSU – dermatologist. Geneva, Switzerland
Source of information: Gieler U. Body dysmorphic disorder. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige)
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