ABSTRACT
In 1886, Morselli described patients who were obsessed about their ugliness and were convinced that others perceived them as ugly, even though their appearance was objectively normal. The essential feature of body dysmorphic disorder (BDD) is preoccupation with an imagined defect in appearance in a normal-appearing person or markedly excessive concern about a slight imperfection. The criteria regarding degree of distress and functional impairment distinguish BDD from the lesser degrees of dissatisfaction with appearance that are common in this culture. BDD is an extreme manifestation of body image distortion and dissatisfaction. Impairment in social and occupational functioning is often extreme. BDD can have a devastating impact on a person’s life, with hours each day being consumed by worry, rituals, and efforts at camouflage. Cognitive-Behavioral Therapy requires determining the cognitive processes and behaviors that are maintaining patients’ BDD and undermining functioning.
