Dysmorphic disorders: Clinical and nosological heterogeneity
The clinical picture of dysmorphophobia (DMP) (dysmorphia, DM) has been inadequately investigated; its descriptions are contradictory. Objective: to study the clinical structure of DMP (DM) on a sample of plastic or cosmetic surgery patients. Patients and methods. An examination was made in of 103 patients, including 81 (78.6%) women (mean age, 35.84.9 years) and 22 (21.4%) men (mean age, 30.95.7 years), who had gone to a clinic of cosmetic or plastic surgery with complaints of objectively unverified appearance defects and DM signs and given consent to take part in the investigation. All the patients underwent clinical and psychopathological examination; in so doing the follow-up data in the past 1-3 tears were borne in mind. Their somatic condition was analyzed on the basis of the data available in the medical documents and the results of laboratory, clinical, and instrumental studies. Results. The dysmorphic syndrome has been found to have overvalued, hypochondriacal, obsessive-compulsive, depressive, and delusional forms. It has been established that DM can manifest within schizophrenia, personality disorders, affective disorders, and organic mental diseases. Differential diagnostic criteria for different types of DM in heterogeneous psychopathological disorders are given.
1 Department of Psychiatry, Psychotherapy, Psychosomatic Pathology, Faculty of Advanced Training of Medical Workers, Medical Institute, Peoples' Friendship University of Russia, 6 Miklukho-Maklai St., Moscow, 117198, Russian Federation