Low self-esteem is an important factor associated with body dysmorphic concerns. In treatment, self-esteem cannot always be adequately addressed. Internet-based interventions offer a low-threshold and cost-efficient possibility for treating body dysmorphic disorder (BDD).

For this reason, we conducted two studies to explore the effectiveness of an internet-based intervention targeting improving self-esteem in adults with BDD symptoms.

The first study investigated the differential effects of a 1-week self-esteem training compared with a 1-week attention-focus training. Two hundred twenty adults with elevated body dysmorphic symptoms were randomly assigned to one of the two trainings. Our second study (n = 58 adults with body dysmorphic symptoms) evaluated an extended 2-week stand-alone self-esteem training.

In the first study, self-esteem in different domains (appearance, performance and social), self-focused attention, and BDD symptom severity improved in both groups. Other-focused attention only increased in the attention training group. Participants’ overall adherence was high. In the second study we observed significant improvements in self-esteem, BDD symptom severity, and other secondary outcomes, with additional improvements in most outcomes in the second week. Adherence was again high.

Together, these findings show that a brief internet-based intervention may be a highly accepted and effective way of improving self-esteem in people suffering from BDD symptoms.

Body dysmorphic disorder (BDD) is a psychiatric illness in which the Patients seeking cosmetic surgery are usually unsatisfied with the outcomes of the surgery. Therefore, it is essential to study this phenomenon and increase awareness among physicians to assess for the presence of BDD before any cosmetic treatment.

To assess the presence of BDD among female patients undergoing cosmetic procedures and improve awareness among providers of cosmetic treatment.

This cross-sectional study uses the adult version of the BDD modification of the Y-BOCS (BDD-YBOCS) scale. Its consists of 12 items related to preoccupied thoughts that participants have about their appearance and the effects that these thoughts have on their lives. Questionnaires were distributed on different online platforms among females living in the eastern province of Saudi Arabia.

Out of the 220 women who participated, 45 had BDD (prevalence rate of 20.5%), a significant and worrying percentage. The result indicates more among participants in the age group of 20–35 years. Also, it revealed positive correlation exists between BDD and females seeking cosmetic procedures.

One-fifth of the participants were diagnosed to be suffering from BDD. Higher rates were observed among women who underwent cosmetic procedures. Therefore, we recommend physicians conduct screening for patients seeking cosmetic procedures before starting any treatment.

No significant relationships.

Body Dysmorphic Disorder (BDD) is a severe and common disorder that consists of distressing or impairing preoccupation with nonexistent or slight flaws in one’s physical appearance. People with BDD typically describe themselves as looking ugly, unattractive, deformed, or abnormal, whereas in reality they look normal or even very attractive.

Case Study

Case Study

Mr. X is a 31 year-old male with history of Opiate (heroin, oxycodone) use disorder currently on maintenance (Buprenorphine-Naloxone) treatment. On admission, urine toxicology was positive for opiates and other drugs.CIWA score was 11. He was started on Lorazepam taper, Mirtazapine, Fluoxetine, and was started on Suboxone soon after. His cravings decreased and he was admitted for Rehab. He reports that anxiety associated with his “body image” related to ears, shape of head, eyebrows since he was in high school which made him “feel uncomfortable” going to school and concentrating in his classes. His coping mechanism was covering his head with hats, shaving eyebrows, substance use, and receiving an otoplasty.

According to Houchins et al (2019), alcohol is the predominant substance used in BDD. It is interesting to note that only 6% of BDD patients had Opioid Use Disorder, but as this case demonstrates, can be a debilitating comorbidity that raises the risk for suicidality or hospitalization. However, little research has been done on the treatment of OUDs in patients with BDD or on the treatment of BDD in patients with an SUD, and this is an area of research that could benefit the modern population greatly.

No significant relationships.

Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with non-existent or slight defects in appearance. It was first described in 1886 by Morselli as dysmorphophobia.

This work reviews the current available data on BDD and its treatment options and describes a clinical case that reports an improvement in symptomatology after surgery.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “body dysmorphic disorder”, “dysmorphophobia”. Clinical file consultation.

The usual treatment involves a combination of psychotherapy and pharmacotherapy. Antidepressant medication, mainly selective serotonin reuptake inhibitors (SSRIs) have been used. If the symptoms do not improve, a different SSRI can be considered or clomipramine, venlafaxine or second-generation antipsychotics can be useful.

The role of surgery remains controversial, several studies indicating that the symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. However a recent study reported 32 of the 41 patients that underwent surgery were highly satisfied with the outcome. In our clinical case, our patient, a 20-year-old female with non-delusional dysmorphic ideas about her nose initiated treatment with paroxetine with poor response and was, against medical opinion, submitted to a rhinoplasty. Three weeks after the surgery there was an improvement in preoccupation about her nose. More research should be made to clarify the role of surgery in this disorder that often lacks adequate therapeutical response.

No significant relationships.

Serotonin-reuptake inhibitors (SRIs) are first-line pharmacotherapy for the treatment of body dysmorphic disorder (BDD), a common and severe disorder. However, prior research has not focused on or identified definitive predictors of SRI treatment outcomes. Leveraging precision medicine techniques such as machine learning can facilitate the prediction of treatment outcomes.

The study used 10-fold cross-validation support vector machine (SVM) learning models to predict three treatment outcomes (i.e. response, partial remission, and full remission) for 97 patients with BDD receiving up to 14-weeks of open-label treatment with the SRI escitalopram. SVM models used baseline clinical and demographic variables as predictors. Feature importance analyses complemented traditional SVM modeling to identify which variables most successfully predicted treatment response.

SVM models indicated acceptable classification performance for predicting treatment response with an area under the curve (AUC) of 0.77 (sensitivity = 0.77 and specificity = 0.63), partial remission with an AUC of 0.75 (sensitivity = 0.67 and specificity = 0.73), and full remission with an AUC of 0.79 (sensitivity = 0.70 and specificity = 0.79). Feature importance analyses supported constructs such as better quality of life and less severe depression, general psychopathology symptoms, and hopelessness as more predictive of better treatment outcome; demographic variables were least predictive.

The current study is the first to demonstrate that machine learning algorithms can successfully predict treatment outcomes for pharmacotherapy for BDD. Consistent with precision medicine initiatives in psychiatry, the current study provides a foundation for personalized pharmacotherapy strategies for patients with BDD.

Body dysmorphic disorder (BDD) is a severe and undertreated condition. Although cognitive-behavioral therapy (CBT) is the first-line psychosocial treatment for this common disorder, how the intervention works is insufficiently understood. Specific pathways have been hypothesized, but only one small study has examined the precise nature of treatment effects of CBT, and no prior study has examined the effects of supportive psychotherapy (SPT).

This study re-examined a large trial (n = 120) comparing CBT to SPT for BDD. Network intervention analyses were used to explore symptom-level data across time. We computed mixed graphical models at multiple time points to examine relative differences in direct and indirect effects of the two interventions.

In the resulting networks, CBT and SPT appeared to differentially target certain symptoms. The largest differences included CBT increasing efforts to disengage from and restructure unhelpful thoughts and resist BDD rituals, while SPT was directly related to improvement in BDD-related insight. Additionally, the time course of differences aligned with the intended targets of CBT; cognitive effects emerged first and behavioral effects second, paralleling cognitive restructuring in earlier sessions and the emphasis on exposure and ritual prevention in later sessions. Differences in favor of CBT were most consistent for behavioral targets.

CBT and SPT primarily affected different symptoms. To improve patient care, the field needs a better understanding of how and when BDD treatments and treatment components succeed. Considering patient experiences at the symptom level and over time can aid in refining or reorganizing treatments to better fit patient needs.

Anorexia nervosa (AN) and bulimia nervosa (BN) take one of the first places in the risk of fatal outcome among eating disorders, have a tendency to chronicity and high suicidal risk. Psychopathological basis for AN and BN is a dysmorfofobia or a pathological dissatisfaction with one’s body, characterized by intrusive, overvalued or delusional ideas of physical disability. Dysmorfofobia affects the formation of affective pathology and reduces the life quality.

The study of the correlation between the degree of dissatisfaction with one’s bodies, affective disorders and life quality of patients with AN and BN.

130 female patients with AN and BN at the age of 13-44 years (the average age is 18). The disease duration from 6 months to 24 years. Validated Questionnaire image of one’s own body (QIOB) and the Scale of satisfaction with one’s body (SSOB); Hospital anxiety and depression scale (Zigmond A.); Questionnaire for the assessment of life quality (SF-36); Microsoft Excel standard correlation calculation.

Dissatisfaction with one’s body based on QIOB and SSOB tests has a significant positive correlation with anxiety and depression, a significant correlation with the psychological component of health, a weak correlation with the physical component of health.

Dissatisfaction with one’s body or dysmorfofobia of patients with AN and BN significantly affects their affective state and psychological component of life quality which leads to a decrease in functioning up to social maladaptation and disability to social maladjustment. The publication was prepared with the support of the “RUDN University Program 5-100”.

The Coronavirus pandemic has originated unprecedented sanitary control measures that have conditioned people’s lifestyles and habits. Little is known about the impact of such measures, especially the most restrictive, on recent and growing phenomena such as exercise addiction, use of enhancement drugs, and Body Dysmorphic Disorder (BDD).

The objective was to investigate the above-mentioned phenomena during COVID-19 pandemic and how they relate.

The sample consisted of 3161 participants (65% women), from Portugal (11%), Italy (41%), Spain (16%), the UK (12%), Lithuania (12%), Japan (6%), and Hungary (4%). Mean age was 35.05 (SD = 12.10). Participants responded online to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and questions about use of enhancement drugs.

4.3% of the participants scored above the cut-off point of the EAI, with higher values registered in the UK and Spain. Exercise addiction was higher among men. Appearance anxiety and body satisfaction problems were found in participants of all participating countries, with 15.2% scoring over the cut-off point for BDD. Higher numbers of those at risk of BDD were found in Italy, Japan, and Portugal. About 29% reported the use of fitness supplements to make them look better, with 6.4% starting a new use during the lockdown. Change in supplements use and exercise are predicted by EAI scores. Change in mental health is predicted by AAI scores.

This study helps to shed light on how COVID-19 lookdown induced behavioral changes and how they affect physical and mental health-related aspects in different countries.

Anorexia nervosa (AN) and bulimia nervosa (BN) occur predominantly females, take one of the first places in the risk of fatal outcome among mental disorders, have a tendency to chronicity, disability with social disadaptation, high suicidal risk. The psychopathological basis of these diseases is dysmorphophobia, characterized intrusive, overvalued or delusional ideas of physical disability. The significant role of dysmorphophobia determines the urgency of the detailed study using psychometric techniques.

Assess the degree of satisfaction/dissatisfaction with one’s body and its separate parts in patients with AN and BN.

130 female patients with AN and BN at the age of 13-44 years (the average age is 18). The disease duration from 6 months to 24 years. The psychometric method using the validated Questionnaire image of one’s own body (QIOB) and the Scale of satisfaction with one’s body (SSOB).

According to QIOB 84,62% in the category expressed dissatisfaction with their appearance, 15,38% in moderate category. According to SSOB, 32,31% of the patients is not satisfied with characteristics that belong to head, 45,38% is not satisfied with characteristics that belong to torso, 56,92% is not satisfied with characteristics that belong to the lower part of body. The number of dissatisfied with all of these body parts equals 38% which indicates the presence of polydismorfofobia.

High rates of dissatisfaction with one’s appearance, which are consistent with the severe somatic state of patients, affect the dynamics and outcome of the disease. Publication was prepared with support of the “RUDN University Program 5-100”.