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)
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
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