[Body dysmorphic disorder: One Hundred Years of Solitude].

Body dysmorphic disorder is a common psychiatric disease; its respective prevalence is 2% in the general population, 3.3% in tertiary students, 7.4% among adolescent and adult psychiatric in-patients, and above 10% in patients of cosmetic surgery or dermatology. The most important symptom of the disease is the distorted perception of bodily appearance that leads to low self-esteem, anxiety, depression, social isolation and compulsive behaviours. The disease usually begins during adolescence (average age at onset: 16.7 years), the symptoms have a rather deleterious impact on social relationships, education, work and family life. Comorbidity with affective disorders, anxiety disorders, personality disorders, eating disorders, alcoholism, and substance use disorders is common. The life quality of the affected patients is bad, the risk of suicide is high, and the occurrence of heteroaggressive behaviour is not infrequent either. Despite the great prevalence and the serious consequences, body dysmorphic disorder is diagnosed only in 15% of the cases, and it occurs relatively rarely that the individuals affected by the disease get an adequate treatment. The patients do not usually ask for help because they feel ashamed, or they look for help in wrong places because of lack of insight. In addition, quite many experts working in the health service are not sufficiently familiar with the pheno - mena of this disorder. The authors' objective is to provide a thorough review about body dysmorphic disorder with special regard to the results of the past decade. A substantial recent change is the fact that the disorder, previously categorized in the group of somatoform disorders, has been placed in the group of obsessive-compulsive and related disorders in DSM-5. A complex interplay of biological, psychological and sociocultural factors underlies the etio - patho genesis. Pharmacotherapy with serotonin reuptake inhibitors and cognitive-behavioural therapy are still regarded as the most effective treatments for body dysmorphic disorder. The modifications of the latter developed to target misperception of appearance, emotional dysfunction or perfectionism seem to represent promising therapeutic measures in addition to the application of novel methods of information technology.