Body dysmorphic disorder: recognizing and treating imagined ugliness.

Body dysmorphic disorder (BDD), also known as dysmorphophobia, is a severe psychiatric disorder that occurs around the world. However, the diagnosis is usually missed in clinical settings. It is important to recognize and diagnose BDD, because this disorder is relatively common and causes significant distress and impairment in functioning. It is also associated with markedly poor quality of life. Although research on effective treatment is still limited, serotonin reuptake inhibitors (SRIs) are currently considered the medication treatment of choice. For symptoms to improve, a relatively high SRI dose and at least 12 weeks of treatment is often needed. The psychosocial treatment of choice is cognitive behavioral therapy, consisting of elements such as exposure, response prevention, behavioral experiments, and cognitive restructuring. Although knowledge of BDD is rapidly increasing, further research is needed on all aspects of this disorder, including treatment studies, epidemiology studies, and investigation of its cross-cultural features and pathogenesis.