Tignol Jean, Martin-Guehl Corinne, Aouizerzate Bruno
Faculté de médecine de l'université de Bordeaux, 33000 Bordeaux, France.
Presse Med. 2012 Jan;41(1):e22-35. doi: 10.1016/j.lpm.2011.05.021. Epub 2011 Aug 9.
Body Dysmorphic Disorder (BDD) has replaced the old and ill-defined concept of dysmorphophobia since its introduction as a full-blown disorder in DSM-III-R in 1987. Since then, the body of knowledge on BDD has considerably increased. At the same time, cosmetic medicine and surgical procedures, for which the indications and outcomes of BDD should be taken into account, have become common. Hence, we decided to undertake a review of the literature on BDD aimed at French speaking practitioners.
We searched Medline for the literature on BDD and dysmorphophobia in English and in French and made a critical examination of findings resulting from those studies where the methodology was sound.
BDD is frequent in the general population with a point prevalence between 1.7 and 2.4% and often severe. Delusive and non-delusive forms of BDD likely belong to the same entity and both respond to the same treatment. Serotonin reuptake inhibitors and cognitive behavioral therapies have demonstrated their efficacy in randomized controlled studies. Esthetic, medical and surgical treatments, which are very often sought after by BDD patients, have been shown to be ineffective and potentially harmful.
Our review confirms the progress in knowledge on BDD. The most interesting results concern clinical characteristics, epidemiology in the general population, and treatment. The prevalence of BDD in the general population should prompt every practitioner to take this disorder into account when faced with the increasing demand for medical and surgical cosmetic procedures. Nevertheless, further research is needed, particularly on the demand of non psychiatric treatments by BDD patients and the way medical or surgical specialists manage it.
自1987年《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）将身体变形障碍（BDD）作为一种全面性疾病引入以来，它已取代了旧的、定义不明确的畸形恐惧症概念。从那时起，关于BDD的知识体系有了显著增长。与此同时，在考虑BDD的适应症和治疗结果时，美容医学和外科手术已变得很常见。因此，我们决定针对法语区的从业者对BDD相关文献进行综述。
我们在Medline中检索了关于BDD和畸形恐惧症的英文及法文文献，并对那些方法合理的研究结果进行了批判性审视。
BDD在普通人群中很常见，点患病率在1.7%至2.4%之间，且往往较为严重。BDD的妄想型和非妄想型可能属于同一实体，且对相同的治疗均有反应。5-羟色胺再摄取抑制剂和认知行为疗法在随机对照研究中已证明了其疗效。BDD患者经常寻求的美容、医学和外科治疗已被证明是无效的，且可能有害。
我们的综述证实了关于BDD的知识进展。最有趣的结果涉及临床特征、普通人群中的流行病学以及治疗。BDD在普通人群中的患病率应促使每位从业者在面对日益增长的医学和外科美容手术需求时考虑到这种疾病。然而，仍需要进一步研究，特别是关于BDD患者对非精神科治疗的需求以及医学或外科专科医生对此的处理方式。
