Khoodoruth Mohamed Adil Shah, Khan Yasser Saeed
Chief Psychiatry Resident, Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar.
Consultant Child and Adolescent Psychiatrist, Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar.
SAGE Open Med Case Rep. 2020 Sep 11;8:2050313X20952976. doi: 10.1177/2050313X20952976. eCollection 2020.
There are very few existing reports in adolescents about the clinical presentation and treatment challenges associated with body dysmorphic disorder coexisting with suicidal behaviour. This case report describes a 13-year old male with body dysmorphic disorder, who was completely convinced that his belief related to the disorder is true (delusional belief) and therefore had no insight into his condition. His preoccupation with the shape of his nose progressed significantly over a 2-year period to the extent that he wore a surgical mask on a daily basis to camouflage the perceived defect. The distress due to the persistent preoccupation and intrusive thinking became so severe that he started to experience suicidal ideation and attempted suicide twice with no harm sustained. This case report focuses on three treatment challenges faced by the treating team: the need of continued treatment with pharmacotherapy and psychotherapy following a cosmetic procedure, the impact of the mother's preoccupation with her physical appearance on the recovery of the young person, and the management of suicidality. We have also highlighted the probable causative factors of the development of the illness in this patient which are consistent with the established aetiology of body dysmorphic disorder.
关于青少年中与身体变形障碍并存自杀行为相关的临床表现和治疗挑战，现有报告极少。本病例报告描述了一名患有身体变形障碍的13岁男性，他完全坚信与该障碍相关的信念是真实的（妄想信念），因此对自己的病情毫无洞察力。他对鼻子形状的过度关注在两年内显著加剧，以至于他每天都戴着外科口罩来掩盖所察觉到的缺陷。由于持续的过度关注和强迫性思维所带来的痛苦变得极为严重，以至于他开始出现自杀念头，并两次试图自杀但均未造成伤害。本病例报告聚焦于治疗团队面临的三个治疗挑战：整形手术后继续进行药物治疗和心理治疗的必要性、母亲对自身外貌的过度关注对年轻人康复的影响以及自杀行为的管理。我们还强调了该患者病情发展的可能致病因素，这些因素与已确定的身体变形障碍病因相符。
