Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T18:05:18.797Z Has data issue: false hasContentIssue false

Body dysmorphic disorder treated with venlafaxine, olanzapine and cognitive behavioural therapy

Published online by Cambridge University Press:  13 June 2014

Mary Clarke
Affiliation:
St John of God Hospital, Stillorgan, Co Dublin, Ireland

Abstract

Body dysmorphic disorder (BDD, previously called dysmorphophobia) is an excessive preoccupation with trivial or non-existent physical abnormalities, perceived to be deformities. BDD causes significant distress or functional impairment and is both time-consuming and difficult to control. Feelings of low self-esteem, shame, embarrassment and unworthiness are common, as is fear of rejection. This report presents a case of BDD in a young male who sought surgery abroad in an effort to ameliorate his perceived deformity. His suicidal ideation, low mood and anxiety symptoms responded well to venlafaxine, olanzapine and cognitive behavioural therapy; however his overvalued ideas with regard to his physical appearance were slow to improve.

Type
Case Reports
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.ICD-10: Classification of Mental and Behavioural Disorders. Geneva: World Health Organisation, 1993.Google Scholar
2.DSM-IV: Diagnostic and Statistical Manual of Mental Disorders– Fourth Edition. American Psychiatric Association, 1994.Google Scholar
3.Phillips, KA, Diaz, S. Gender differences in body dysmorphic disorder. J Nerv Ment Dis 1997; 185: 570–7.CrossRefGoogle ScholarPubMed
4.Perugi, G, Aklskal, HS, Giannotti, D, Frare, F, DiValio, S, Cassano, GB. J Nerv Ment Dis 1997; 185(9): 578–82.CrossRefGoogle Scholar
5.Josephson, SC, Hollander, E. Body dysmorphic disorder by proxy. J Clin Psychiatry 1997; 58(2): 86–7.CrossRefGoogle ScholarPubMed
6.Faravelli, C, Salvatori, S, Galassi, F, Aiazzi, L, Drei, C, Cabras, P. Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychlatr Epidemiol 1997; 32(1): 24–9.CrossRefGoogle ScholarPubMed
7.Phillips, KA, McElroy, SL, Keck, PE Jr, Pope, HG Jr, Hudson, JI. A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases. Psychopharmacology Bulletin 1994; 30: 179–86.Google ScholarPubMed
8.Phillips, KA. The broken mirror: understanding and treating body dysmorphic disorder. New York: Oxford University Press, 1996.Google Scholar
9.Phillips, KA, McElroy, SL, Keck, PE Jr, Pope, HG Jr, Hudson, JI. Body dysmorphic disorder: 30 cases of Imagined ugliness. Am J Psychiatry 1993; 150: 302–8.Google ScholarPubMed
10.Goodacre, TEE, Mayou, R. Dysmorphophobia in plastic surgery and its treatment. Treatment of functional somatic symptoms. Oxford: Oxford University Press, 1995: 231–51.CrossRefGoogle Scholar
11.Andreason, NC, and Bardach, J. Dysmorphophobia: symptom or disease? Am J Psychiatry 1977; 134: 673–5.Google Scholar
12.Perugi, G, Giannotti, D, Frare, F, Saettoni, M, Cassano, GB. Int Clin Psychopharmacol 1996; 11 (4): 247–54.CrossRefGoogle Scholar
13.Phillips, KA, Albertini, RS, Rasmussen, SA. A randomised placebo-controlled trial of fluoxetine in body dysmorphic disorder. Arch Gen Psychiatry 2002; 59: 381–8.CrossRefGoogle ScholarPubMed
14.Ananth, J, Burgoyne, K, Smith, M, Swartz, R. Venlafaxine for the treatment of obsessive-compulsive disorder. Am J Psychiatry 1996; 152(12): 1832.Google Scholar
15.Rauch, SL, O' Sullivan, RL, Jenike, MA. Open treatment of obsessive-compulsive disorder with venlafaxine: a series often cases. J Clin Psychopharmacol 1996; 16(1): 81–4.CrossRefGoogle ScholarPubMed
16.Grossman, R, Hollander, E. Treatment of obsessive-compulsive disorder with venlafaxine. Am J Psychiatry 1996; 153(4): 576–7.Google ScholarPubMed
17.Phillips, K. Olanzapine augmentation of fluoxetine in body dysmorphic disorder. Am J Psychiatry 2005; 162: 1022–23.CrossRefGoogle ScholarPubMed
18.Grant, JE. Successful treatment of nondelusional body dysmorphic disorder with olanzapine: a case report. J Clin Psychiatry 2001; 62: 297–8.CrossRefGoogle ScholarPubMed
19.Phillips, KA. Placebo-controlled study of pimozide augmentation of fluoxetine in body dysmorphic disorder. Am J Psychiatry 2005; 162(2): 377–9.CrossRefGoogle ScholarPubMed
20.Neziroglu, FA, Yaryura-Tobias, JA. Exposure, response prevention and cognitive therapy in the treatment of body dysmorphic disorder. Behaviour Therapy 1993; 24; 431–8.CrossRefGoogle Scholar
21.Veale, D, Gournay, K, Dryden, W, Boocock, A, Shah, F, Willson, R, Walburn, J. Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behav Res Ther 1996; 34(9): 717–29.CrossRefGoogle ScholarPubMed
22.Veale, D. Cognitive-behavioural therapy for body dysmorphic disorder. Advances in psychiatric treatment 2001; 7: 125–32.CrossRefGoogle Scholar
23.Phillips, KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry 2004; 3(1); 1218.Google ScholarPubMed