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Body Dysmorphic Disorder (BDD) Fear of Imagined Ugliness


Treatment of BDD involves the use of pharmacotherapy and cognitive behavioural therapy (CBT), used alone or simultaneously.

Drug Assisted Treatment
The specific serotonin re - uptake inhibitors (SSRIs) and the tricyclic antidepressant - clomipramine have been shown to be the most efficacious pharmacological intervention. The most widely used and studied SSRI is Fluvoxamine (Luvox). Other SSRIs that studies have shown to be effective include Fluoxetine (Prozac) and Citalopram (Cipramil). Some limited studies have claimed that the atypical antipsychotics - Olanzapine (Zyprexa) and Quetiapine (Seroquel) may also be efficacious.

Cognitive Behavioural Therapy (CBT)
Applied individually or conducted in groups, CBT is showing promise in the treatment of BDD. Cognitive therapy involves identifying and challenging faulty thoughts and beliefs responsible for maintaining BDD, then replacing those cognitions with more realistic ways of thinking. The behavioural therapies shown to be useful are exposure and response prevention therapy. In exposure therapy, the sufferer is encouraged, in a graded way, to expose the defect or defects in an environment or situation where exposure has been avoided. Response prevention therapy aims to inhibit the compulsive behaviours of self - examination and comparing.

Non - psychiatric Treatments
To reduce their ugliness, BDD sufferers often seek consultations with dermatologists, cosmetic and dental surgeons. Up to 7% who seek cosmetic surgery, do so repeatedly. The surgery is invariably unsuccessful and, for some, an exacerbation of symptoms occurs. If the surgery is successful, the site of the preoccupation may change.

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