Body Dysmorphic Disorder

Psychiatric MONDO:0000690 Pathograph 14 Show in embeddings browser Psychiatric Disease Obsessive-Compulsive and Related Disorder

Body dysmorphic disorder (BDD) is an obsessive-compulsive-related psychiatric disorder defined by persistent preoccupation with perceived appearance flaws that are not observable or appear slight to others, together with repetitive checking, comparison, camouflaging, grooming, or related mental acts. Insight is often poor or absent. The disorder commonly begins before adulthood, substantially impairs social, educational, and occupational functioning, and is associated with considerable self-harm and suicide risk.

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1
Mappings
6
Pathophys.
5
Phenotypes
3
Gaps
14
Pathograph
4
Medical Actions
5
Differentials
3
Trials
10
References
1
Deep Research
🏷

Classifications

Harrison's Part
NEUROLOGIC
🔗

Mappings

MONDO
MONDO:0000690 body dysmorphic disorder
skos:exactMatch MONDO
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Discussions and Knowledge Gaps

3
Are altered visual-attention, global-local processing, and visual-emotional-network findings developmental causal mechanisms of BDD, state effects of persistent preoccupation, or nonspecific correlates?
KNOWLEDGE GAP OPEN gap_bdd_mechanism_causality
Attached to
pathophysiology#Aberrant Visual Attention and Global-Local Processing pathophysiology#Persistent Appearance Preoccupation
Most studies are small, cross-sectional, adult, and incompletely replicated. Establishing directionality would determine whether perceptual retraining addresses a causal mechanism or only a downstream correlate.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"A few studies suggest functional and structural brain differences (compared with controls) in the regions involved in visual and emotional processing, although firm conclusions about the pathophysiology of the disorder cannot be made at this stage."
The primer explicitly states that firm pathophysiologic conclusions are premature.
Which specific genetic variants and prospectively measured environmental exposures contribute causally to clinically diagnosed BDD, after accounting for familial and gene-environment correlation confounding?
KNOWLEDGE GAP OPEN gap_bdd_genetic_environmental_causality
Attached to
pathophysiology#Partly Heritable and Environmentally Modulated Liability environmental#Peer victimization and childhood trauma
Twin estimates concern self-reported dysmorphic traits, no BDD GWAS was available in the primer, and proposed environmental risks derive mainly from designs that cannot establish causality.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"To date, no genome-wide association studies of BDD diagnoses or symptoms have"
The primer identifies the absence of BDD genomic association studies.
PMID:39639018 SUPPORT Human Clinical
"failure to control for familial or genetic confounding."
The primer identifies a key limitation of environmental-risk studies.
Does single-dose psilocybin provide durable efficacy and acceptable safety beyond expectancy, psychological support, and natural symptom variation in treatment-resistant BDD?
KNOWLEDGE GAP OPEN gap_bdd_psilocybin_controlled_evidence
Attached to
clinical_trials#NCT04656301
Published findings derive from a very small uncontrolled pilot. Psilocybin remains experimental and is not represented as an established treatment.
Show evidence (1 reference)
PMID:40458078 SUPPORT Human Clinical
"Given the small sample size and uncontrolled design of the study, larger controlled studies are necessary to validate these observations."
The published pilot explicitly states the need for controlled validation.
⚙

Pathophysiology

6
Partly Heritable and Environmentally Modulated Liability
BDD liability is probably multifactorial. Twin estimates for self-reported dysmorphic concerns indicate a partly heritable component, while adverse experiences and other environmental factors remain putative. No BDD diagnosis or symptom GWAS had been reported in the 2024 primer.
Downstream
Negative Appearance Appraisal and Rumination Multifactorial liability is placed upstream of the cognitive-affective appraisal branch, but the responsible intermediates are unknown.
Aberrant Visual Attention and Global-Local Processing Multifactorial liability is placed upstream of the perceptual-processing branch, with developmental and molecular intermediates unresolved.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"Research on the aetiology of BDD is scarce but likely involves an interplay between genetic and environmental factors."
The review supports a multifactorial liability model while emphasizing that etiologic evidence remains sparse.
PMID:39639018 SUPPORT Human Clinical
"dysmorphic concerns ranges between 37 and 49%"
Twin studies estimate heritability of self-reported dysmorphic concerns, not a clinically diagnosed BDD genotype.
Negative Appearance Appraisal and Rumination
Cognitive-behavioral models propose that negative appraisal of appearance and repeated rumination generate and maintain appearance-focused preoccupation and associated affect.
Downstream
Persistent Appearance Preoccupation Repeated negative appearance appraisals and rumination are represented as the proximal cognitive route to persistent preoccupation.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"appraisals of aspects of one's appearance and repeated thoughts and rumination"
The primer describes this cognitive-affective model, but it remains a theory of symptom formation and maintenance rather than a confirmed biological mechanism.
Aberrant Visual Attention and Global-Local Processing
Eye-tracking, behavioral, and neuroimaging studies suggest selective attention to perceived flaws, atypical visual scanning, and an imbalance between detail-oriented and holistic processing. Small samples, inconsistencies, and limited replication make this a provisional mechanism.
neuron CL:0000540 Cell Ontology (CL) Relation: this pathophysiological event involves this cell type This pathophysiological event involves neuron (CL:0000540). CL:0000540 is a cell type from the Cell Ontology.
brain UBERON:0000955 Uberon multi-species anatomy ontology (UBERON) Relation: this pathophysiological event occurs in this anatomical location This pathophysiological event occurs in brain (UBERON:0000955). UBERON:0000955 is an anatomical location from the Uberon multi-species anatomy ontology.
Downstream
Persistent Appearance Preoccupation Biased visual attention may increase the salience of perceived flaws and contribute to preoccupation; the direction and intervening mechanisms remain uncertain.
Show evidence (1 reference)
DOI:10.1038/s41398-022-02099-2 SUPPORT Human Clinical
"In individuals with body dysmorphic disorder (BDD), perceptual appearance distortions may be related to selective attention biases and aberrant visual scanning, contributing to imbalances in global vs. detailed visual processing."
An unmedicated adult fMRI and eye-tracking study supports the proposed perceptual-processing abnormality but does not establish that it causes BDD.
Persistent Appearance Preoccupation
The established clinical core of BDD is intense, persistent preoccupation with perceived defects or flaws that are not observable or appear slight to others.
Downstream
Repetitive Checking, Camouflaging, Comparison, and Avoidance Appearance preoccupation elicits repetitive behaviors and mental acts intended to check, correct, compare, conceal, or avoid perceived flaws.
Appearance-related preoccupation This node instantiates the defining abnormal-preoccupation phenotype.
Poor or absent insight Conviction in appearance beliefs ranges from good to absent insight, with many affected people ambivalent or convinced that the beliefs are true.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder-related psychiatric condition characterized by an intense preoccupation with perceived physical flaws that are not observable by others."
The primer states the defining preoccupation directly.
Repetitive Checking, Camouflaging, Comparison, and Avoidance
Repetitive appearance checking, comparing, grooming, camouflaging, seeking reassurance, and avoidance are established behavioral manifestations. Cognitive-behavioral models propose that these responses maintain the disorder.
Downstream
Compulsive appearance-related behaviors This node instantiates the compulsive-behavior phenotype.
Persistent Symptom Maintenance Repetitive responses and avoidance are modeled as maintaining appearance-focused preoccupation and distress.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"Diagnosis requires the presence of repetitive behaviours or mental acts typically aimed at checking, correcting or concealing perceived flaws."
The primer identifies these behaviors as required diagnostic features.
Persistent Symptom Maintenance
Cognitive-behavioral models propose that appearance-focused preoccupation, rumination, checking, camouflaging, comparison, and avoidance participate in maintenance of BDD symptoms. The direction and intervening links among these responses remain provisional.
Downstream
Suicidal ideation Persistent BDD is associated with suicidal ideation, but the mediating psychological and comorbidity pathways are not fully resolved.
Self-injurious behavior Intentional self-harm is strongly associated with diagnosed BDD, although the cohort design does not identify a direct causal route.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"and maintenance of BDD symptoms"
The primer describes a cognitive-behavioral maintenance model, while the direction and mediating feedback mechanisms remain unresolved.
⬡

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Body Dysmorphic Disorder Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.
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Phenotypes

5
Nervous System 4
Poor or absent insight Delusion HP:0000746 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Delusion (HP:0000746). HP:0000746 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"ambivalent or even convinced that the beliefs are true (that is, poor or absent insight)."
The primer supports poor-to-absent insight. HPO Delusion is used as the closest available phenotype term but does not capture the full insight continuum.
Suicidal ideation HP:0031589 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Suicidal ideation (HP:0031589). HP:0031589 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:30806630 SUPPORT Human Clinical
"and often leads to suicidal ideation."
The clinical review directly identifies suicidal ideation in BDD.
Self-injurious behavior HP:0100716 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Self-injurious behavior (HP:0100716). HP:0100716 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
PMID:38734199 SUPPORT Human Clinical
"Among 2833 individuals with BDD and 28,330 unexposed matched individuals, 466 (16.45%) and 1071 (3.78%), respectively, had at least 1 record of intentional self-harm during the study period"
The nationwide cohort directly quantifies intentional self-harm in BDD compared with matched unexposed individuals.
Other 1
💊

Medical Actions

4
BDD-tailored cognitive behavioral therapy
Category: Therapeutic Action: cognitive behavior therapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is cognitive behavior therapy (NCIT:C64345). NCIT:C64345 is a clinical intervention from the NCI Thesaurus. Ontology label: Cognitive Behavior Therapy NCIT:C64345
First-line BDD-specific CBT combines psychoeducation and formulation, engagement in a psychological understanding, exposure with response prevention, behavioral experiments, cognitive restructuring, and relapse prevention. Attention or mirror retraining and modules for muscle dysmorphia, skin picking, or hair pulling can be added when indicated.
Mechanism Target:
MODULATES Negative Appearance Appraisal and Rumination — Cognitive restructuring and behavioral experiments reappraise exaggerated appearance beliefs.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"components of CBT include psychoeducation and formulation, engagement in an alternative"
The primer describes the core BDD-specific CBT formulation.
INHIBITS Repetitive Checking, Camouflaging, Comparison, and Avoidance — Exposure with response prevention reduces avoidance and repetitive safety behaviors.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"exposure with response prevention and behavioural"
The primer names exposure with response prevention as a core CBT component.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Compulsive behaviors HP:0000722 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Compulsive behaviors (HP:0000722). HP:0000722 is a phenotype from the Human Phenotype Ontology. Delusion HP:0000746 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Delusion (HP:0000746). HP:0000746 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"CBT is the most evidence-based psychological treatment for BDD"
The primer identifies BDD-tailored CBT as the best-supported psychotherapy.
PMID:30785624 SUPPORT Human Clinical
"Body dysmorphic disorder severity and associated symptoms appeared to improve with both CBT-BDD and supportive psychotherapy, although CBT-BDD was associated with more consistent improvement in symptom severity and quality of life."
This 120-participant randomized trial supports CBT-BDD while preserving the site-specific and active-control nuance.
Therapist-guided internet-delivered CBT
Category: Therapeutic Action: cognitive behavior therapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is cognitive behavior therapy (NCIT:C64345). NCIT:C64345 is a clinical intervention from the NCI Thesaurus. Ontology label: Cognitive Behavior Therapy NCIT:C64345
Low-intensity therapist-guided internet CBT extends access to BDD-specific treatment. Evidence is strongest for mild-to-moderate presentations, and a current randomized trial is evaluating efficacy, cost-effectiveness, and durability in children and adolescents.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Compulsive behaviors HP:0000722 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Compulsive behaviors (HP:0000722). HP:0000722 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT06262412 SUPPORT Human Clinical
"The purpose of this trial is to evaluate the clinical efficacy, the cost-effectiveness and the 6-month durability of a therapist-guided, Internet-delivered cognitive-behavior therapy programme for children and adolescents with body dysmorphic disorder."
The active randomized trial directly evaluates guided internet CBT in young people with BDD.
Selective serotonin reuptake inhibitor pharmacotherapy
Category: Therapeutic Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Agent: selective serotonin reuptake inhibitor NCIT:C94725 NCI Thesaurus (NCIT) Relation: this treatment uses this therapeutic agent This treatment uses selective serotonin reuptake inhibitor (NCIT:C94725). NCIT:C94725 is a therapeutic agent from the NCI Thesaurus.
SSRIs such as fluoxetine, sertraline, and escitalopram are first-line pharmacotherapy for adults with BDD. Treatment response does not establish a serotonergic cause of BDD, and youth evidence remains limited.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Compulsive behaviors HP:0000722 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Compulsive behaviors (HP:0000722). HP:0000722 is a phenotype from the Human Phenotype Ontology. Delusion HP:0000746 Human Phenotype Ontology (HP) Relation: this treatment targets this phenotype This treatment targets Delusion (HP:0000746). HP:0000746 is a phenotype from the Human Phenotype Ontology.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"Evidence-based treatments include cognitive behavioural therapy and selective serotonin reuptake inhibitors."
The primer identifies SSRIs as evidence-based BDD treatment.
PMID:27056606 SUPPORT Human Clinical
"Phase 2 relapse proportions were 18% for escitalopram and 40% for placebo."
Among acute escitalopram responders, randomized continuation reduced six-month relapse relative to placebo substitution.
Regular self-harm, suicide, and unsafe-procedure safety monitoring
Category: Monitoring Action: supportive careNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is supportive care (NCIT:C15747). NCIT:C15747 is a clinical intervention from the NCI Thesaurus. Ontology label: Supportive Care NCIT:C15747
Reassess self-harm, suicidal thoughts and behaviors, and risky do-it-yourself or unwarranted cosmetic procedures throughout care. Escalate immediately to severity-appropriate safety management when risk is acute.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"Careful and regular risk assessment is a crucial component of BDD management."
The primer explicitly makes regular risk assessment part of management.
PMID:38734199 SUPPORT Human Clinical
"A total of 17 (0.60%) individuals with BDD and 27 (0.10%) unexposed individuals died by suicide (hazard ratio = 3.47; 95% CI, 1.76-6.85)."
The nationwide cohort quantifies the elevated mortality risk that motivates ongoing safety monitoring.
🌍

Environmental Factors

1
Peer victimization and childhood trauma
Bullying, abuse, neglect, and related adverse experiences have been proposed as BDD risk factors. Current studies are largely cross-sectional and may be affected by familial, genetic, and gene-environment correlation confounding.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"peer victimization (bullying) and childhood trauma"
The primer identifies these exposures as putative environmental risks.
PMID:39639018 SUPPORT Human Clinical
"failure to control for familial or genetic confounding."
This explicit limitation prevents treating the exposure associations as established causal risk factors.
🔬

Diagnosis

4
BDD-focused screening followed by guided assessment (A positive BDD-focused screen prompts comprehensive assessment; diagnosis requires appearance preoccupation, repetitive behaviors or mental acts, distress or impairment, and appropriate exclusions.)
BDDQ, COPS, or a structured appearance-concern question can identify people requiring further evaluation, but a positive screen is not diagnostic and should be followed by a guided assessment of full criteria.
clinical assessment NCIT:C124351 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"should be followed by a more extensive, guided assessment to establish whether diagnostic"
The primer explicitly states that screening tools must be followed by a fuller guided diagnostic assessment.
Specialist mental-health diagnostic evaluation (Clinical criteria are met when appearance-focused preoccupation and repetitive responses cause distress or impairment and are not better explained by an eating disorder, another medical condition, a substance, or medication.)
A psychiatrist or psychologist assesses symptom focus, repetitive behaviors, impairment, insight, muscle-dysmorphia specifier, eating-disorder exclusion, psychosis features, substance or medication effects, and whether any visible difference is slight relative to the preoccupation.
psychiatrist evaluation NCIT:C124351 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"The diagnosis of BDD is generally made by a specialist in mental health"
The primer identifies specialist mental-health evaluation as usual.
BDD-YBOCS severity and outcome assessment (A 30% or greater reduction is commonly used as a treatment-response threshold, while a score of 16 or below can indicate partial or full remission.)
The clinician-rated BDD-YBOCS and adolescent BDD-YBOCS-A quantify symptom severity and monitor treatment response or remission; they supplement rather than replace diagnostic assessment.
psychologist evaluation NCIT:C124351 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"Yale-Brown Obsessive–Compulsive Scale modified for BDD (BDD-YBOCS)"
The primer identifies BDD-YBOCS and BDD-YBOCS-A for severity assessment.
Self-harm, suicide, and unsafe-procedure risk assessment (Positive risk findings require immediate severity-appropriate safety management and follow-up.)
Every assessment should evaluate current and past self-harm, suicidal thoughts and behaviors, and intent to pursue unwarranted or unsafe cosmetic procedures.
clinical assessment NCIT:C124351 NCI Thesaurus (NCIT)
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"assessment process should also include a risk assessment for self-harm, suicidality and"
The primer explicitly includes self-harm and suicide risk in BDD assessment, together with unsafe cosmetic-procedure risk.
📈

Progression

2
Typical onset
Age: Childhood through adolescence
Approximately two thirds of affected people develop BDD before age 18, although recognition and specialist treatment may occur later.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"The disorder typically has its onset before 18 years of age"
The primer identifies onset before adulthood as typical.
Persistent untreated disorder
Age: Adolescence through adulthood
Long-term untreated natural-history cohorts are unavailable. Expert consensus considers untreated BDD likely to be chronic, so this phase should not be interpreted as a quantified longitudinal trajectory.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"BDD typically follows a chronic course if left untreated"
The primer reports expert clinical consensus rather than prospective, untreated long-term natural-history evidence.
📊

Prevalence

1
Adults in community-based samples from high-income countries
Point Prevalence 2000.0 per 100,000 >1 in 1,000
This is a weighted community estimate. Prevalence is substantially higher in psychiatric, cosmetic-surgery, and dermatology settings.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"BDD affects ~2% of the adult population"
The 2024 disease primer gives the approximate adult population prevalence.
⚖️

Clinical Burden

High
BDD can consume hours each day, disrupt social, educational, and occupational functioning, markedly reduce quality of life, and carry major self-harm and suicide risk. Poor insight and pursuit of cosmetic procedures can delay appropriate care.
Show evidence (2 references)
PMID:39639018 SUPPORT Human Clinical
"Quality of life is markedly impaired across multiple domains and suicide risk is considerable."
The disease primer directly supports substantial functional burden and suicide risk.
PMID:38734199 SUPPORT Human Clinical
"BDD was associated with a 3-fold increased risk of intentional self-harm and death by suicide."
A nationwide matched cohort quantifies the serious self-harm and mortality burden.
🔀

Differential Diagnoses

5

Conditions with similar clinical presentations that must be differentiated from Body Dysmorphic Disorder:

Obsessive-Compulsive Disorder MONDO:0008114
Overlapping Features OCD and BDD can both involve impairing repetitive thoughts and behaviors, but BDD thoughts and corrective responses are specifically focused on perceived appearance defects.
Distinguishing Features
  • BDD thoughts are exclusively appearance-focused; OCD obsessions span broader themes.
  • BDD repetitive acts attempt to inspect, hide, or fix perceived appearance flaws.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"In BDD, the repetitive thoughts are exclusively focused on the appearance, whereas in OCD the thoughts may focus on a broader range of obsessions."
The primer's differential table directly distinguishes BDD from OCD.
Eating Disorder Not Yet Curated MONDO:0005451
Overlapping Features Eating disorders and BDD both involve image-related preoccupation, but eating disorders center on body weight or shape and dysfunctional eating.
Distinguishing Features
  • Multiple facial, head, or generalized perceived defects favor BDD; intense weight-loss focus with restriction, bingeing, or purging favors an eating disorder.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"In eating disorders, the preoccupation is generally focused on body weight and body shape, whereas in BDD the appearance preoccupations tend to be multiple and mainly focused on facial features/head area or be more general"
The primer's differential table directly contrasts the focus of eating disorders and BDD.
Trichotillomania MONDO:0013189
Overlapping Features Hair removal can occur in either disorder. In BDD it is an attempt to improve a perceived appearance flaw, whereas in trichotillomania it is a habitual behavior associated with pleasure or stress relief.
Distinguishing Features
  • Appearance-correction intent favors BDD.
  • Habitual pulling for pleasure or stress relief favors trichotillomania.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"In BDD, behaviour will correspond to an attempt to improve appearance by removing specific hairs that are considered unattractive. This is not the case in trichotillomania, where the pulling is a habit that is pleasurable or helps with stress relief"
The primer's differential table directly distinguishes the motivation for hair removal.
Social Anxiety Disorder MONDO:0001247
Overlapping Features Both disorders can involve fear of negative evaluation and social avoidance. In BDD these concerns center on perceived appearance defects and provoke appearance-focused repetitive behavior.
Distinguishing Features
  • Fear centered on performance or embarrassment without appearance-fixing behavior favors social anxiety disorder.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"In BDD, these symptoms are related to the perceived appearance defects, whereas in social anxiety, these concerns are not central, but they tend to be related with the social performance and a fear of embarrassing oneself."
The primer's differential table distinguishes the focus of social fear in BDD and social anxiety disorder.
Delusional Disorder Not Yet Curated MONDO:0004359
Overlapping Features Absent insight in BDD can resemble delusional belief, but BDD retains its appearance-focused preoccupation and repetitive responses and lacks the broader positive symptoms expected in a psychotic disorder.
Distinguishing Features
  • Disorganized thought or speech, hallucinations, and other positive psychotic symptoms favor a psychotic disorder rather than BDD with absent insight.
Show evidence (1 reference)
PMID:39639018 SUPPORT Human Clinical
"Despite individuals with BDD having absent insight and delusional ideas, they will not present disorganized thoughts, disorganized speech, hallucinations, or other positive symptoms generally present in psychotic disorders"
The primer contrasts BDD with psychotic disorders generally; applying the distinction specifically to delusional disorder is therefore partial.
🔬

Clinical Trials

3
NCT06262412 NOT_APPLICABLE RECRUITING
Randomized evaluation of therapist-guided internet CBT for children and adolescents with BDD, including clinical efficacy, cost-effectiveness, and six-month durability. The registry listed an estimated enrollment of 154 when checked on 2026-07-23.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Compulsive behaviors HP:0000722 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Compulsive behaviors (HP:0000722). HP:0000722 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT06262412 SUPPORT Human Clinical
"The purpose of this trial is to evaluate the clinical efficacy, the cost-effectiveness and the 6-month durability of a therapist-guided, Internet-delivered cognitive-behavior therapy programme for children and adolescents with body dysmorphic disorder."
The registry record directly describes the randomized digital-CBT trial.
NCT04373629 NOT_APPLICABLE RECRUITING
Human mechanistic study of neural, behavioral, and emotional contributors to abnormal perceptual processing and its malleability with visual modulation. The registry listed estimated enrollment of 146 and remained recruiting when checked on 2026-07-23.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Delusion HP:0000746 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Delusion (HP:0000746). HP:0000746 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT04373629 SUPPORT Human Clinical
"Results from this study will provide a comprehensive mechanistic model of brain, behavioral, and emotional contributors to abnormal perceptual processing, as well as how malleable it is with visual modulation techniques."
The registry describes the trial's perceptual-mechanism objective.
NCT04656301 PHASE_II COMPLETED
Completed open-label pilot of one 25-mg oral psilocybin dose with psychological support in 12 adults whose BDD had not responded to at least one adequate serotonin-reuptake-inhibitor trial.
Target Phenotypes: Abnormal preoccupation HP:0025785 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Abnormal preoccupation (HP:0025785). HP:0025785 is a phenotype from the Human Phenotype Ontology. Compulsive behaviors HP:0000722 Human Phenotype Ontology (HP) Relation: this clinical trial targets this phenotype This clinical trial targets Compulsive behaviors (HP:0000722). HP:0000722 is a phenotype from the Human Phenotype Ontology.
Show evidence (1 reference)
clinicaltrials:NCT04656301 SUPPORT Human Clinical
"In this pilot study 12 adult outpatients with body dysmorphic disorder that has not responded to at least one adequate trial of a serotonin reuptake inhibitor will be treated openly with a single oral dose of psilocybin."
The registry directly describes the small open-label pilot design.
{ }

Source YAML

click to show 
name: Body Dysmorphic Disorder
creation_date: "2026-04-28T00:00:00Z"
category: Psychiatric
description: >-
  Body dysmorphic disorder (BDD) is an obsessive-compulsive-related psychiatric
  disorder defined by persistent preoccupation with perceived appearance flaws
  that are not observable or appear slight to others, together with repetitive
  checking, comparison, camouflaging, grooming, or related mental acts. Insight
  is often poor or absent. The disorder commonly begins before adulthood,
  substantially impairs social, educational, and occupational functioning, and
  is associated with considerable self-harm and suicide risk.
disease_term:
  preferred_term: body dysmorphic disorder
  term:
    id: MONDO:0000690
    label: body dysmorphic disorder
mappings:
  mondo_mappings:
  - term:
      id: MONDO:0000690
      label: body dysmorphic disorder
    mapping_predicate: skos:exactMatch
    mapping_source: MONDO
parents:
- Psychiatric Disease
- Obsessive-Compulsive and Related Disorder
synonyms:
- BDD
- Body dysmorphia
prevalence:
- population: Adults in community-based samples from high-income countries
  measure_type: POINT_PREVALENCE
  prevalence_class: ABOVE_1_IN_1000
  rate_per_100000: 2000.0
  notes: >-
    This is a weighted community estimate. Prevalence is substantially higher
    in psychiatric, cosmetic-surgery, and dermatology settings.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: BDD affects ~2% of the adult population
    explanation: >-
      The 2024 disease primer gives the approximate adult population
      prevalence.
progression:
- phase: Typical onset
  age_range: Childhood through adolescence
  notes: >-
    Approximately two thirds of affected people develop BDD before age 18,
    although recognition and specialist treatment may occur later.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The disorder typically has its onset before 18 years of age
    explanation: The primer identifies onset before adulthood as typical.
- phase: Persistent untreated disorder
  age_range: Adolescence through adulthood
  notes: >-
    Long-term untreated natural-history cohorts are unavailable. Expert
    consensus considers untreated BDD likely to be chronic, so this phase
    should not be interpreted as a quantified longitudinal trajectory.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: BDD typically follows a chronic course if left untreated
    explanation: >-
      The primer reports expert clinical consensus rather than prospective,
      untreated long-term natural-history evidence.
clinical_burden:
  burden_level: HIGH
  rationale: >-
    BDD can consume hours each day, disrupt social, educational, and
    occupational functioning, markedly reduce quality of life, and carry major
    self-harm and suicide risk. Poor insight and pursuit of cosmetic procedures
    can delay appropriate care.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Quality of life is markedly impaired across multiple domains and suicide risk is considerable.
    explanation: >-
      The disease primer directly supports substantial functional burden and
      suicide risk.
  - reference: PMID:38734199
    reference_title: "Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: BDD was associated with a 3-fold increased risk of intentional self-harm and death by suicide.
    explanation: >-
      A nationwide matched cohort quantifies the serious self-harm and mortality
      burden.
pathophysiology:
- name: Partly Heritable and Environmentally Modulated Liability
  description: >-
    BDD liability is probably multifactorial. Twin estimates for self-reported
    dysmorphic concerns indicate a partly heritable component, while adverse
    experiences and other environmental factors remain putative. No BDD
    diagnosis or symptom GWAS had been reported in the 2024 primer.
  mechanism_confidence: PROVISIONAL
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Research on the aetiology of BDD is scarce but likely involves an interplay between genetic and environmental factors.
    explanation: >-
      The review supports a multifactorial liability model while emphasizing
      that etiologic evidence remains sparse.
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: dysmorphic concerns ranges between 37 and 49%
    explanation: >-
      Twin studies estimate heritability of self-reported dysmorphic concerns,
      not a clinically diagnosed BDD genotype.
  downstream:
  - target: Negative Appearance Appraisal and Rumination
    description: >-
      Multifactorial liability is placed upstream of the cognitive-affective
      appraisal branch, but the responsible intermediates are unknown.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Research on the aetiology of BDD is scarce but likely involves an interplay between genetic and environmental factors.
      explanation: >-
        The primer supports broad etiologic liability but does not establish a
        direct route to cognitive appraisal.
  - target: Aberrant Visual Attention and Global-Local Processing
    description: >-
      Multifactorial liability is placed upstream of the perceptual-processing
      branch, with developmental and molecular intermediates unresolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        A few studies suggest functional and structural brain differences
        (compared with controls) in the regions involved in visual and emotional
        processing, although firm conclusions about the pathophysiology of the
        disorder cannot be made at this stage.
      explanation: >-
        Human studies support a provisional perceptual-processing branch, not a
        resolved causal path from liability.
- name: Negative Appearance Appraisal and Rumination
  description: >-
    Cognitive-behavioral models propose that negative appraisal of appearance
    and repeated rumination generate and maintain appearance-focused
    preoccupation and associated affect.
  mechanism_confidence: PROVISIONAL
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: appraisals of aspects of one's appearance and repeated thoughts and rumination
    explanation: >-
      The primer describes this cognitive-affective model, but it remains a
      theory of symptom formation and maintenance rather than a confirmed
      biological mechanism.
  downstream:
  - target: Persistent Appearance Preoccupation
    description: >-
      Repeated negative appearance appraisals and rumination are represented as
      the proximal cognitive route to persistent preoccupation.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: appraisals of aspects of one's appearance and repeated thoughts and rumination
      explanation: >-
        The cited cognitive model explicitly treats these repeated thoughts as
        preoccupations; causal confirmation remains incomplete.
- name: Aberrant Visual Attention and Global-Local Processing
  description: >-
    Eye-tracking, behavioral, and neuroimaging studies suggest selective
    attention to perceived flaws, atypical visual scanning, and an imbalance
    between detail-oriented and holistic processing. Small samples,
    inconsistencies, and limited replication make this a provisional mechanism.
  mechanism_confidence: PROVISIONAL
  cell_types:
  - preferred_term: neuron
    term:
      id: CL:0000540
      label: neuron
  locations:
  - preferred_term: brain
    term:
      id: UBERON:0000955
      label: brain
  evidence:
  - reference: DOI:10.1038/s41398-022-02099-2
    reference_title: Neural and behavioral effects of modification of visual attention in body dysmorphic disorder
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In individuals with body dysmorphic disorder (BDD), perceptual appearance
      distortions may be related to selective attention biases and aberrant
      visual scanning, contributing to imbalances in global vs. detailed visual
      processing.
    explanation: >-
      An unmedicated adult fMRI and eye-tracking study supports the proposed
      perceptual-processing abnormality but does not establish that it causes
      BDD.
  downstream:
  - target: Persistent Appearance Preoccupation
    description: >-
      Biased visual attention may increase the salience of perceived flaws and
      contribute to preoccupation; the direction and intervening mechanisms
      remain uncertain.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: DOI:10.1038/s41398-022-02099-2
      reference_title: Neural and behavioral effects of modification of visual attention in body dysmorphic disorder
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        In individuals with body dysmorphic disorder (BDD), perceptual
        appearance distortions may be related to selective attention biases and
        aberrant visual scanning, contributing to imbalances in global vs.
        detailed visual processing.
      explanation: >-
        The study supports association between visual attention and appearance
        distortion; directionality toward preoccupation remains provisional.
- name: Persistent Appearance Preoccupation
  description: >-
    The established clinical core of BDD is intense, persistent preoccupation
    with perceived defects or flaws that are not observable or appear slight to
    others.
  mechanism_confidence: ESTABLISHED
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder-related
      psychiatric condition characterized by an intense preoccupation with
      perceived physical flaws that are not observable by others.
    explanation: The primer states the defining preoccupation directly.
  downstream:
  - target: Repetitive Checking, Camouflaging, Comparison, and Avoidance
    description: >-
      Appearance preoccupation elicits repetitive behaviors and mental acts
      intended to check, correct, compare, conceal, or avoid perceived flaws.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Diagnosis requires the presence of repetitive behaviours or mental acts
        typically aimed at checking, correcting or concealing perceived flaws.
      explanation: >-
        The diagnostic relationship directly couples perceived flaws to
        repetitive checking, correction, and concealment responses.
  - target: Appearance-related preoccupation
    description: This node instantiates the defining abnormal-preoccupation phenotype.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder-related
        psychiatric condition characterized by an intense preoccupation with
        perceived physical flaws that are not observable by others.
      explanation: The disease definition directly supports this phenotype edge.
  - target: Poor or absent insight
    description: >-
      Conviction in appearance beliefs ranges from good to absent insight, with
      many affected people ambivalent or convinced that the beliefs are true.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: ambivalent or even convinced that the beliefs are true (that is, poor or absent insight).
      explanation: >-
        This directly supports poor or absent insight; HPO Delusion is an
        approximate ontology representation and is therefore marked partial.
- name: Repetitive Checking, Camouflaging, Comparison, and Avoidance
  description: >-
    Repetitive appearance checking, comparing, grooming, camouflaging, seeking
    reassurance, and avoidance are established behavioral manifestations.
    Cognitive-behavioral models propose that these responses maintain the
    disorder.
  mechanism_confidence: ESTABLISHED
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Diagnosis requires the presence of repetitive behaviours or mental acts
      typically aimed at checking, correcting or concealing perceived flaws.
    explanation: The primer identifies these behaviors as required diagnostic features.
  downstream:
  - target: Compulsive appearance-related behaviors
    description: This node instantiates the compulsive-behavior phenotype.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Diagnosis requires the presence of repetitive behaviours or mental acts
        typically aimed at checking, correcting or concealing perceived flaws.
      explanation: The diagnostic behavior directly supports the phenotype edge.
  - target: Persistent Symptom Maintenance
    description: >-
      Repetitive responses and avoidance are modeled as maintaining
      appearance-focused preoccupation and distress.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: and maintenance of BDD symptoms
      explanation: >-
        Cognitive-behavioral theory addresses symptom maintenance, but the
        omitted mediators and causal direction are not fully established.
- name: Persistent Symptom Maintenance
  description: >-
    Cognitive-behavioral models propose that appearance-focused preoccupation,
    rumination, checking, camouflaging, comparison, and avoidance participate
    in maintenance of BDD symptoms. The direction and intervening links among
    these responses remain provisional.
  mechanism_confidence: PROVISIONAL
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: and maintenance of BDD symptoms
    explanation: >-
      The primer describes a cognitive-behavioral maintenance model, while the
      direction and mediating feedback mechanisms remain unresolved.
  downstream:
  - target: Suicidal ideation
    description: >-
      Persistent BDD is associated with suicidal ideation, but the mediating
      psychological and comorbidity pathways are not fully resolved.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:30806630
      reference_title: "[Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment]."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: and often leads to suicidal ideation.
      explanation: >-
        The clinical review identifies suicidal ideation as an important BDD
        outcome; the edge remains indirect because mediators are unresolved.
  - target: Self-injurious behavior
    description: >-
      Intentional self-harm is strongly associated with diagnosed BDD, although
      the cohort design does not identify a direct causal route.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:38734199
      reference_title: "Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: BDD was associated with a 3-fold increased risk of intentional self-harm and death by suicide.
      explanation: >-
        The adjusted nationwide cohort supports a strong association but not a
        direct causal mechanism.
phenotypes:
- name: Appearance-related preoccupation
  category: Psychiatric
  diagnostic: true
  description: >-
    Persistent and disproportionate concern with perceived physical appearance
    flaws that are absent or slight to others.
  phenotype_term:
    preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder-related
      psychiatric condition characterized by an intense preoccupation with
      perceived physical flaws that are not observable by others.
    explanation: The primer directly supports the defining preoccupation phenotype.
- name: Compulsive appearance-related behaviors
  category: Psychiatric
  diagnostic: true
  description: >-
    Repetitive checking, comparison, grooming, camouflaging, reassurance
    seeking, correction attempts, or related mental acts performed in response
    to appearance concerns.
  phenotype_term:
    preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Diagnosis requires the presence of repetitive behaviours or mental acts
      typically aimed at checking, correcting or concealing perceived flaws.
    explanation: The primer directly supports repetitive appearance-related behaviors.
- name: Poor or absent insight
  category: Psychiatric
  description: >-
    Insight exists on a continuum; many affected people are ambivalent about or
    convinced of the truth of their appearance beliefs.
  phenotype_term:
    preferred_term: Delusion
    term:
      id: HP:0000746
      label: Delusion
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: ambivalent or even convinced that the beliefs are true (that is, poor or absent insight).
    explanation: >-
      The primer supports poor-to-absent insight. HPO Delusion is used as the
      closest available phenotype term but does not capture the full insight
      continuum.
- name: Suicidal ideation
  category: Psychiatric
  description: Suicidal ideation is a clinically important adverse outcome in BDD.
  phenotype_term:
    preferred_term: Suicidal ideation
    term:
      id: HP:0031589
      label: Suicidal ideation
  evidence:
  - reference: PMID:30806630
    reference_title: "[Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment]."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: and often leads to suicidal ideation.
    explanation: The clinical review directly identifies suicidal ideation in BDD.
- name: Self-injurious behavior
  category: Psychiatric
  description: >-
    Intentional self-harm, including nonsuicidal self-injury and suicide
    attempts, occurs at substantially elevated rates in people diagnosed with
    BDD.
  phenotype_term:
    preferred_term: Self-injurious behavior
    term:
      id: HP:0100716
      label: Self-injurious behavior
  evidence:
  - reference: PMID:38734199
    reference_title: "Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Among 2833 individuals with BDD and 28,330 unexposed matched individuals,
      466 (16.45%) and 1071 (3.78%), respectively, had at least 1 record of
      intentional self-harm during the study period
    explanation: >-
      The nationwide cohort directly quantifies intentional self-harm in BDD
      compared with matched unexposed individuals.
environmental:
- name: Peer victimization and childhood trauma
  presence: Putative risk association; causality not established
  description: >-
    Bullying, abuse, neglect, and related adverse experiences have been proposed
    as BDD risk factors. Current studies are largely cross-sectional and may be
    affected by familial, genetic, and gene-environment correlation confounding.
  effect: Possible contribution to multifactorial liability
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: peer victimization (bullying) and childhood trauma
    explanation: The primer identifies these exposures as putative environmental risks.
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: failure to control for familial or genetic confounding.
    explanation: >-
      This explicit limitation prevents treating the exposure associations as
      established causal risk factors.
diagnosis:
- name: BDD-focused screening followed by guided assessment
  description: >-
    BDDQ, COPS, or a structured appearance-concern question can identify people
    requiring further evaluation, but a positive screen is not diagnostic and
    should be followed by a guided assessment of full criteria.
  diagnosis_term:
    preferred_term: clinical assessment
    term:
      id: NCIT:C124351
      label: Clinical Evaluation
  presence: >-
    A positive BDD-focused screen prompts comprehensive assessment; diagnosis
    requires appearance preoccupation, repetitive behaviors or mental acts,
    distress or impairment, and appropriate exclusions.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: should be followed by a more extensive, guided assessment to establish whether diagnostic
    explanation: >-
      The primer explicitly states that screening tools must be followed by a
      fuller guided diagnostic assessment.
- name: Specialist mental-health diagnostic evaluation
  description: >-
    A psychiatrist or psychologist assesses symptom focus, repetitive
    behaviors, impairment, insight, muscle-dysmorphia specifier, eating-disorder
    exclusion, psychosis features, substance or medication effects, and whether
    any visible difference is slight relative to the preoccupation.
  diagnosis_term:
    preferred_term: psychiatrist evaluation
    term:
      id: NCIT:C124351
      label: Clinical Evaluation
  presence: >-
    Clinical criteria are met when appearance-focused preoccupation and
    repetitive responses cause distress or impairment and are not better
    explained by an eating disorder, another medical condition, a substance, or
    medication.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The diagnosis of BDD is generally made by a specialist in mental health
    explanation: The primer identifies specialist mental-health evaluation as usual.
- name: BDD-YBOCS severity and outcome assessment
  description: >-
    The clinician-rated BDD-YBOCS and adolescent BDD-YBOCS-A quantify symptom
    severity and monitor treatment response or remission; they supplement rather
    than replace diagnostic assessment.
  diagnosis_term:
    preferred_term: psychologist evaluation
    term:
      id: NCIT:C124351
      label: Clinical Evaluation
  presence: >-
    A 30% or greater reduction is commonly used as a treatment-response
    threshold, while a score of 16 or below can indicate partial or full
    remission.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Yale-Brown Obsessive–Compulsive Scale modified for BDD (BDD-YBOCS)
    explanation: The primer identifies BDD-YBOCS and BDD-YBOCS-A for severity assessment.
- name: Self-harm, suicide, and unsafe-procedure risk assessment
  description: >-
    Every assessment should evaluate current and past self-harm, suicidal
    thoughts and behaviors, and intent to pursue unwarranted or unsafe cosmetic
    procedures.
  diagnosis_term:
    preferred_term: clinical assessment
    term:
      id: NCIT:C124351
      label: Clinical Evaluation
  presence: >-
    Positive risk findings require immediate severity-appropriate safety
    management and follow-up.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: assessment process should also include a risk assessment for self-harm, suicidality and
    explanation: >-
      The primer explicitly includes self-harm and suicide risk in BDD
      assessment, together with unsafe cosmetic-procedure risk.
differential_diagnoses:
- name: Obsessive-Compulsive Disorder
  description: >-
    OCD and BDD can both involve impairing repetitive thoughts and behaviors,
    but BDD thoughts and corrective responses are specifically focused on
    perceived appearance defects.
  distinguishing_features:
  - BDD thoughts are exclusively appearance-focused; OCD obsessions span broader themes.
  - BDD repetitive acts attempt to inspect, hide, or fix perceived appearance flaws.
  disease_term:
    preferred_term: obsessive-compulsive disorder
    term:
      id: MONDO:0008114
      label: obsessive-compulsive disorder
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In BDD, the repetitive thoughts are exclusively focused on the appearance,
      whereas in OCD the thoughts may focus on a broader range of obsessions.
    explanation: The primer's differential table directly distinguishes BDD from OCD.
- name: Eating Disorder
  description: >-
    Eating disorders and BDD both involve image-related preoccupation, but
    eating disorders center on body weight or shape and dysfunctional eating.
  distinguishing_features:
  - >-
    Multiple facial, head, or generalized perceived defects favor BDD; intense
    weight-loss focus with restriction, bingeing, or purging favors an eating
    disorder.
  disease_term:
    preferred_term: eating disorder
    term:
      id: MONDO:0005451
      label: eating disorder
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In eating disorders, the preoccupation is generally focused on body weight
      and body shape, whereas in BDD the appearance preoccupations tend to be
      multiple and mainly focused on facial features/head area or be more
      general
    explanation: >-
      The primer's differential table directly contrasts the focus of eating
      disorders and BDD.
- name: Trichotillomania
  description: >-
    Hair removal can occur in either disorder. In BDD it is an attempt to
    improve a perceived appearance flaw, whereas in trichotillomania it is a
    habitual behavior associated with pleasure or stress relief.
  distinguishing_features:
  - Appearance-correction intent favors BDD.
  - Habitual pulling for pleasure or stress relief favors trichotillomania.
  disease_term:
    preferred_term: trichotillomania
    term:
      id: MONDO:0013189
      label: trichotillomania
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In BDD, behaviour will correspond to an attempt to improve appearance by
      removing specific hairs that are considered unattractive. This is not the
      case in trichotillomania, where the pulling is a habit that is pleasurable
      or helps with stress relief
    explanation: >-
      The primer's differential table directly distinguishes the motivation for
      hair removal.
- name: Social Anxiety Disorder
  description: >-
    Both disorders can involve fear of negative evaluation and social
    avoidance. In BDD these concerns center on perceived appearance defects and
    provoke appearance-focused repetitive behavior.
  distinguishing_features:
  - >-
    Fear centered on performance or embarrassment without appearance-fixing
    behavior favors social anxiety disorder.
  disease_term:
    preferred_term: social anxiety disorder
    term:
      id: MONDO:0001247
      label: social phobia
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In BDD, these symptoms are related to the perceived appearance defects,
      whereas in social anxiety, these concerns are not central, but they tend
      to be related with the social performance and a fear of embarrassing
      oneself.
    explanation: >-
      The primer's differential table distinguishes the focus of social fear in
      BDD and social anxiety disorder.
- name: Delusional Disorder
  description: >-
    Absent insight in BDD can resemble delusional belief, but BDD retains its
    appearance-focused preoccupation and repetitive responses and lacks the
    broader positive symptoms expected in a psychotic disorder.
  distinguishing_features:
  - >-
    Disorganized thought or speech, hallucinations, and other positive psychotic
    symptoms favor a psychotic disorder rather than BDD with absent insight.
  disease_term:
    preferred_term: delusional disorder
    term:
      id: MONDO:0004359
      label: delusional disorder
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Despite individuals with BDD having absent insight and delusional ideas,
      they will not present disorganized thoughts, disorganized speech,
      hallucinations, or other positive symptoms generally present in psychotic
      disorders
    explanation: >-
      The primer contrasts BDD with psychotic disorders generally; applying the
      distinction specifically to delusional disorder is therefore partial.
treatments:
- name: BDD-tailored cognitive behavioral therapy
  action_category: THERAPEUTIC
  description: >-
    First-line BDD-specific CBT combines psychoeducation and formulation,
    engagement in a psychological understanding, exposure with response
    prevention, behavioral experiments, cognitive restructuring, and relapse
    prevention. Attention or mirror retraining and modules for muscle
    dysmorphia, skin picking, or hair pulling can be added when indicated.
  treatment_term:
    preferred_term: cognitive behavior therapy
    term:
      id: NCIT:C64345
      label: Cognitive Behavior Therapy
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  - preferred_term: Delusion
    term:
      id: HP:0000746
      label: Delusion
  target_mechanisms:
  - target: Negative Appearance Appraisal and Rumination
    treatment_effect: MODULATES
    description: Cognitive restructuring and behavioral experiments reappraise exaggerated appearance beliefs.
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: components of CBT include psychoeducation and formulation, engagement in an alternative
      explanation: The primer describes the core BDD-specific CBT formulation.
  - target: Repetitive Checking, Camouflaging, Comparison, and Avoidance
    treatment_effect: INHIBITS
    description: Exposure with response prevention reduces avoidance and repetitive safety behaviors.
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: exposure with response prevention and behavioural
      explanation: The primer names exposure with response prevention as a core CBT component.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: CBT is the most evidence-based psychological treatment for BDD
    explanation: The primer identifies BDD-tailored CBT as the best-supported psychotherapy.
  - reference: PMID:30785624
    reference_title: "Efficacy and Posttreatment Effects of Therapist-Delivered Cognitive Behavioral Therapy vs Supportive Psychotherapy for Adults With Body Dysmorphic Disorder: A Randomized Clinical Trial."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Body dysmorphic disorder severity and associated symptoms appeared to
      improve with both CBT-BDD and supportive psychotherapy, although CBT-BDD
      was associated with more consistent improvement in symptom severity and
      quality of life.
    explanation: >-
      This 120-participant randomized trial supports CBT-BDD while preserving
      the site-specific and active-control nuance.
- name: Therapist-guided internet-delivered CBT
  action_category: THERAPEUTIC
  description: >-
    Low-intensity therapist-guided internet CBT extends access to BDD-specific
    treatment. Evidence is strongest for mild-to-moderate presentations, and a
    current randomized trial is evaluating efficacy, cost-effectiveness, and
    durability in children and adolescents.
  treatment_term:
    preferred_term: cognitive behavior therapy
    term:
      id: NCIT:C64345
      label: Cognitive Behavior Therapy
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  evidence:
  - reference: clinicaltrials:NCT06262412
    reference_title: "Clinical Efficacy and Cost-effectiveness of Internet-delivered Cognitive-behaviour Therapy for Children and Adolescents With Body Dysmorphic Disorder: a Randomised Controlled Trial"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The purpose of this trial is to evaluate the clinical efficacy, the
      cost-effectiveness and the 6-month durability of a therapist-guided,
      Internet-delivered cognitive-behavior therapy programme for children and
      adolescents with body dysmorphic disorder.
    explanation: >-
      The active randomized trial directly evaluates guided internet CBT in
      young people with BDD.
- name: Selective serotonin reuptake inhibitor pharmacotherapy
  action_category: THERAPEUTIC
  description: >-
    SSRIs such as fluoxetine, sertraline, and escitalopram are first-line
    pharmacotherapy for adults with BDD. Treatment response does not establish a
    serotonergic cause of BDD, and youth evidence remains limited.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: selective serotonin reuptake inhibitor
      term:
        id: NCIT:C94725
        label: Selective Serotonin Reuptake Inhibitor
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  - preferred_term: Delusion
    term:
      id: HP:0000746
      label: Delusion
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Evidence-based treatments include cognitive behavioural therapy and selective serotonin reuptake inhibitors.
    explanation: The primer identifies SSRIs as evidence-based BDD treatment.
  - reference: PMID:27056606
    reference_title: "Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind, Placebo-Controlled Trial."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Phase 2 relapse proportions were 18% for escitalopram and 40% for placebo.
    explanation: >-
      Among acute escitalopram responders, randomized continuation reduced
      six-month relapse relative to placebo substitution.
- name: Regular self-harm, suicide, and unsafe-procedure safety monitoring
  action_category: MONITORING
  description: >-
    Reassess self-harm, suicidal thoughts and behaviors, and risky do-it-yourself
    or unwarranted cosmetic procedures throughout care. Escalate immediately to
    severity-appropriate safety management when risk is acute.
  treatment_term:
    preferred_term: supportive care
    term:
      id: NCIT:C15747
      label: Supportive Care
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Careful and regular risk assessment is a crucial component of BDD management.
    explanation: The primer explicitly makes regular risk assessment part of management.
  - reference: PMID:38734199
    reference_title: "Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      A total of 17 (0.60%) individuals with BDD and 27 (0.10%) unexposed
      individuals died by suicide (hazard ratio = 3.47; 95% CI, 1.76-6.85).
    explanation: >-
      The nationwide cohort quantifies the elevated mortality risk that
      motivates ongoing safety monitoring.
clinical_trials:
- name: NCT06262412
  phase: NOT_APPLICABLE
  status: RECRUITING
  description: >-
    Randomized evaluation of therapist-guided internet CBT for children and
    adolescents with BDD, including clinical efficacy, cost-effectiveness, and
    six-month durability. The registry listed an estimated enrollment of 154
    when checked on 2026-07-23.
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  evidence:
  - reference: clinicaltrials:NCT06262412
    reference_title: "Clinical Efficacy and Cost-effectiveness of Internet-delivered Cognitive-behaviour Therapy for Children and Adolescents With Body Dysmorphic Disorder: a Randomised Controlled Trial"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The purpose of this trial is to evaluate the clinical efficacy, the
      cost-effectiveness and the 6-month durability of a therapist-guided,
      Internet-delivered cognitive-behavior therapy programme for children and
      adolescents with body dysmorphic disorder.
    explanation: The registry record directly describes the randomized digital-CBT trial.
- name: NCT04373629
  phase: NOT_APPLICABLE
  status: RECRUITING
  description: >-
    Human mechanistic study of neural, behavioral, and emotional contributors
    to abnormal perceptual processing and its malleability with visual
    modulation. The registry listed estimated enrollment of 146 and remained
    recruiting when checked on 2026-07-23.
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Delusion
    term:
      id: HP:0000746
      label: Delusion
  evidence:
  - reference: clinicaltrials:NCT04373629
    reference_title: Neural Mechanisms of Perceptual Abnormalities and Their Malleability in Body Dysmorphic Disorder
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Results from this study will provide a comprehensive mechanistic model of
      brain, behavioral, and emotional contributors to abnormal perceptual
      processing, as well as how malleable it is with visual modulation
      techniques.
    explanation: The registry describes the trial's perceptual-mechanism objective.
- name: NCT04656301
  phase: PHASE_II
  status: COMPLETED
  description: >-
    Completed open-label pilot of one 25-mg oral psilocybin dose with
    psychological support in 12 adults whose BDD had not responded to at least
    one adequate serotonin-reuptake-inhibitor trial.
  target_phenotypes:
  - preferred_term: Abnormal preoccupation
    term:
      id: HP:0025785
      label: Abnormal preoccupation
  - preferred_term: Compulsive behaviors
    term:
      id: HP:0000722
      label: Compulsive behaviors
  evidence:
  - reference: clinicaltrials:NCT04656301
    reference_title: Safety and Efficacy of Psilocybin for Body Dysmorphic Disorder
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In this pilot study 12 adult outpatients with body dysmorphic disorder that
      has not responded to at least one adequate trial of a serotonin reuptake
      inhibitor will be treated openly with a single oral dose of psilocybin.
    explanation: The registry directly describes the small open-label pilot design.
discussions:
- discussion_id: gap_bdd_mechanism_causality
  prompt: >-
    Are altered visual-attention, global-local processing, and
    visual-emotional-network findings developmental causal mechanisms of BDD,
    state effects of persistent preoccupation, or nonspecific correlates?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - pathophysiology#Aberrant Visual Attention and Global-Local Processing
  - pathophysiology#Persistent Appearance Preoccupation
  rationale: >-
    Most studies are small, cross-sectional, adult, and incompletely replicated.
    Establishing directionality would determine whether perceptual retraining
    addresses a causal mechanism or only a downstream correlate.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      A few studies suggest functional and structural brain differences
      (compared with controls) in the regions involved in visual and emotional
      processing, although firm conclusions about the pathophysiology of the
      disorder cannot be made at this stage.
    explanation: The primer explicitly states that firm pathophysiologic conclusions are premature.
- discussion_id: gap_bdd_genetic_environmental_causality
  prompt: >-
    Which specific genetic variants and prospectively measured environmental
    exposures contribute causally to clinically diagnosed BDD, after accounting
    for familial and gene-environment correlation confounding?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - pathophysiology#Partly Heritable and Environmentally Modulated Liability
  - environmental#Peer victimization and childhood trauma
  rationale: >-
    Twin estimates concern self-reported dysmorphic traits, no BDD GWAS was
    available in the primer, and proposed environmental risks derive mainly from
    designs that cannot establish causality.
  evidence:
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: To date, no genome-wide association studies of BDD diagnoses or symptoms have
    explanation: The primer identifies the absence of BDD genomic association studies.
  - reference: PMID:39639018
    reference_title: Body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: failure to control for familial or genetic confounding.
    explanation: The primer identifies a key limitation of environmental-risk studies.
- discussion_id: gap_bdd_psilocybin_controlled_evidence
  prompt: >-
    Does single-dose psilocybin provide durable efficacy and acceptable safety
    beyond expectancy, psychological support, and natural symptom variation in
    treatment-resistant BDD?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - clinical_trials#NCT04656301
  rationale: >-
    Published findings derive from a very small uncontrolled pilot. Psilocybin
    remains experimental and is not represented as an established treatment.
  evidence:
  - reference: PMID:40458078
    reference_title: Single-dose psilocybin alters resting state functional networks in patients with body dysmorphic disorder.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Given the small sample size and uncontrolled design of the study, larger
      controlled studies are necessary to validate these observations.
    explanation: The published pilot explicitly states the need for controlled validation.
classifications:
  harrisons_chapter:
  - classification_value: NEUROLOGIC
    evidence:
    - reference: PMID:39639018
      reference_title: Body dysmorphic disorder.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: psychiatric condition characterized by an intense preoccupation
      explanation: >-
        BDD is a psychiatric condition; DisMech maps psychiatric disease to the
        neurologic Harrison's chapter grouping.
datasets: []
references:
- reference: PMID:39639018
  title: Body dysmorphic disorder.
  findings: []
- reference: PMID:38734199
  title: "Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study."
  findings: []
- reference: PMID:30785624
  title: "Efficacy and Posttreatment Effects of Therapist-Delivered Cognitive Behavioral Therapy vs Supportive Psychotherapy for Adults With Body Dysmorphic Disorder: A Randomized Clinical Trial."
  findings: []
- reference: PMID:27056606
  title: "Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind, Placebo-Controlled Trial."
  findings: []
- reference: PMID:40458078
  title: Single-dose psilocybin alters resting state functional networks in patients with body dysmorphic disorder.
  findings: []
- reference: PMID:30806630
  title: "[Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment]."
  findings: []
- reference: DOI:10.1038/s41398-022-02099-2
  title: Neural and behavioral effects of modification of visual attention in body dysmorphic disorder
  findings: []
- reference: clinicaltrials:NCT06262412
  title: "Clinical Efficacy and Cost-effectiveness of Internet-delivered Cognitive-behaviour Therapy for Children and Adolescents With Body Dysmorphic Disorder: a Randomised Controlled Trial"
  findings: []
- reference: clinicaltrials:NCT04373629
  title: Neural Mechanisms of Perceptual Abnormalities and Their Malleability in Body Dysmorphic Disorder
  findings: []
- reference: clinicaltrials:NCT04656301
  title: Safety and Efficacy of Psilocybin for Body Dysmorphic Disorder
  findings: []
review_notes: >-
  Curated from direct review of cached sources, with the Falcon deep-research
  report used only as a discovery aid. BDD is modeled as a multifactorial
  psychiatric disorder without a curated causal gene: twin estimates concern
  self-reported dysmorphic traits, and the 2024 primer reported no BDD GWAS or
  specific causal variants. Cognitive-affective and visual-processing
  mechanisms are explicitly provisional; SSRI efficacy is not treated as proof
  of serotonergic pathophysiology. Anxiety and depressive disorders are common
  comorbidities but were removed from the causal phenotype graph. No validated
  animal model or disease-specific public GEO omics dataset was identified.
  ClinicalTrials.gov was checked on 2026-07-23; BDD-specific trials were retained
  while anorexia, generic body-image, and cosmetic-procedure false positives
  were excluded. Cosmetic procedures are not represented as BDD treatment
  because outcomes are often unpredictable or poor. A Monarch D2P audit on
  2026-07-23 returned no OMIM- or Orphanet-backed BDD phenotype rows and no
  phenotype-completeness issues; direct clinical evidence therefore anchors the
  five curated phenotypes.
📚

References & Deep Research

References

10
PMID:39639018
Body dysmorphic disorder.
No top-level findings curated for this source.
PMID:38734199
Intentional Self-Harm and Death by Suicide in Body Dysmorphic Disorder: A Nationwide Cohort Study.
No top-level findings curated for this source.
PMID:30785624
Efficacy and Posttreatment Effects of Therapist-Delivered Cognitive Behavioral Therapy vs Supportive Psychotherapy for Adults With Body Dysmorphic Disorder: A Randomized Clinical Trial.
No top-level findings curated for this source.
PMID:27056606
Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind, Placebo-Controlled Trial.
No top-level findings curated for this source.
PMID:40458078
Single-dose psilocybin alters resting state functional networks in patients with body dysmorphic disorder.
No top-level findings curated for this source.
PMID:30806630
[Body dysmorphic disorder: Symptoms, prevalence, assessment and treatment].
No top-level findings curated for this source.
DOI:10.1038/s41398-022-02099-2
Neural and behavioral effects of modification of visual attention in body dysmorphic disorder
No top-level findings curated for this source.
clinicaltrials:NCT06262412
Clinical Efficacy and Cost-effectiveness of Internet-delivered Cognitive-behaviour Therapy for Children and Adolescents With Body Dysmorphic Disorder: a Randomised Controlled Trial
No top-level findings curated for this source.
clinicaltrials:NCT04373629
Neural Mechanisms of Perceptual Abnormalities and Their Malleability in Body Dysmorphic Disorder
No top-level findings curated for this source.
clinicaltrials:NCT04656301
Safety and Efficacy of Psilocybin for Body Dysmorphic Disorder
No top-level findings curated for this source.

Deep Research

1
Falcon ▸
Disease Characteristics Research Template
Edison Scientific Literature 22 citations 2026-04-28T10:13:35.596302

Question: You are an expert researcher providing comprehensive, well-cited information.

Provide detailed information focusing on: 1. Key concepts and definitions with current understanding 2. Recent developments and latest research (prioritize 2023-2024 sources) 3. Current applications and real-world implementations 4. Expert opinions and analysis from authoritative sources 5. Relevant statistics and data from recent studies

Format as a comprehensive research report with proper citations. Include URLs and publication dates where available. Always prioritize recent, authoritative sources and provide specific citations for all major claims.

Disease Characteristics Research Template

Target Disease

  • Disease Name: Body Dysmorphic Disorder
  • MONDO ID: (if available)
  • Category: Psychiatric

Research Objectives

Please provide a comprehensive research report on Body Dysmorphic Disorder covering all of the disease characteristics listed below. This report will be used to populate a disease knowledge base entry. Be thorough and cite primary literature (PMID preferred) for all claims.

For each section, suggested databases/resources are listed. These are the first places you should search for information on each topic.

1. Disease Information

Search first: OMIM, Orphanet, ICD-10/ICD-11, MeSH, PubMed

  • What is the disease? Provide a concise overview.
  • What are the key identifiers? (OMIM, Orphanet, ICD-10/ICD-11, MeSH, Mondo)
  • What are the common synonyms and alternative names?
  • Is the information derived from individual patients (e.g., EHR) or aggregated disease-level resources?

2. Etiology

  • Disease Causal Factors: What are the primary causes? (genetic, environmental, infectious, mechanistic)
  • Risk Factors:

    Search first: PubMed, Cochrane Library, UpToDate, clinical guidelines, ClinVar, ClinGen, GWAS Catalog, PheGenI, CTD, CDC, WHO, epidemiological databases

  • Genetic risk factors (causal variants, susceptibility loci, modifier genes)
  • Environmental risk factors (toxins, lifestyle, occupational exposures, age, sex, family history)
  • Protective Factors:

    Search first: PubMed, Cochrane Library, clinical trial databases, GWAS Catalog, gnomAD, WHO, CDC, nutrition databases

  • Genetic protective factors (protective variants, modifier alleles)
  • Environmental protective factors (diet, lifestyle, exposures that reduce risk)
  • Gene-Environment Interactions: How do genetic and environmental factors interact to influence disease?

    Search first: CTD, PubMed, PheGenI, GxE databases

3. Phenotypes

Search first: HPO (Human Phenotype Ontology), OMIM, Orphanet, PubMed, clinicaltrials.gov, MedDRA, SNOMED CT, DECIPHER, LOINC

For each phenotype, provide: - Phenotype type: symptoms, clinical signs, physical manifestations, behavioral changes, or laboratory abnormalities

For symptoms/signs: HPO, OMIM, Orphanet, PubMed For behavioral changes: HPO, DSM, RDoC (Research Domain Criteria), PubMed For laboratory abnormalities: LOINC, SNOMED CT, LabTests Online, PubMed - Phenotype characteristics: Search first: OMIM, Orphanet, HPO, PubMed - Age of symptom onset (neonatal, childhood, adult-onset, late-onset) - Symptom severity (mild, moderate, severe, variable) - Symptom progression (stable, progressive, episodic, fluctuating) - Frequency among affected individuals (percentage or qualitative) - Quality of life impact: Effects on daily functioning and well-being (per-phenotype when possible) Search first: EQ-5D database, SF-36, WHO QOL databases, PubMed - Suggest HPO (Human Phenotype Ontology) terms for each phenotype

4. Genetic/Molecular Information

  • Causal Genes: Gene mutations or chromosomal abnormalities responsible for disease (gene symbols, OMIM IDs)

    Search first: OMIM, ClinVar, HGMD, Ensembl, NCBI Gene

  • Pathogenic Variants:
  • Affected genes (gene symbols, HGNC IDs) > Search first: OMIM, NCBI Gene, Ensembl, HGNC, UniProt, GeneCards
  • Variant classification (pathogenic, likely pathogenic, VUS per ACMG/AMP guidelines) > Search first: ClinVar, ClinGen, ACMG/AMP guidelines, VarSome
  • Variant type/class (missense, frameshift, nonsense, splice-site, structural)
  • Allele frequency in population databases > Search first: gnomAD, 1000 Genomes, ExAC, TOPMed, dbSNP
  • Somatic vs germline origin > Search first: COSMIC (somatic), ClinVar, ICGC, TCGA
  • Functional consequences (loss of function, gain of function, dominant negative)
  • Modifier Genes: Genes that modify disease severity or expression
  • Epigenetic Information: DNA methylation, histone modifications, chromatin changes affecting disease

    Search first: ENCODE, Roadmap Epigenomics, MethBase, DiseaseMeth

  • Chromosomal Abnormalities: Large-scale genetic changes (aneuploidy, translocations, inversions)

    Search first: DECIPHER, ClinVar, ECARUCA, UCSC Genome Browser

5. Environmental Information

  • Environmental Factors: Non-genetic contributing factors (toxins, radiation, pollution, occupational exposure)

    Search first: CTD (Comparative Toxicogenomics Database), TOXNET, PubMed, EPA databases

  • Lifestyle Factors: Behavioral factors (smoking, diet, exercise, alcohol consumption)

    Search first: CDC databases, WHO, PubMed, NHANES

  • Infectious Agents: If applicable, pathogens causing or triggering disease (bacteria, viruses, fungi, parasites)

    Search first: NCBI Taxonomy, ViPR, BV-BRC, MicrobeDB, GIDEON

6. Mechanism / Pathophysiology

  • Molecular Pathways: Specific signaling cascades or biochemical pathways involved (Wnt, MAPK, mTOR, PI3K-AKT, etc.)

    Search first: KEGG, Reactome, WikiPathways, PathBank, BioCyc

  • Cellular Processes: Cell-level mechanisms (apoptosis, autophagy, cell cycle dysregulation, inflammation, etc.)

    Search first: Gene Ontology (GO), Reactome, KEGG, PubMed

  • Protein Dysfunction: How protein structure or function is altered (misfolding, aggregation, loss of function, gain of function)

    Search first: UniProt, PDB (Protein Data Bank), InterPro, Pfam, AlphaFold

  • Metabolic Changes: Alterations in metabolic processes (energy metabolism, lipid metabolism, amino acid metabolism)

    Search first: KEGG, BioCyc, HMDB (Human Metabolome Database), BRENDA

  • Immune System Involvement: Role of immune response (autoimmunity, immunodeficiency, chronic inflammation)

    Search first: ImmPort, Immunome Database, IEDB, Gene Ontology

  • Tissue Damage Mechanisms: How tissues/ are injured (oxidative stress, ischemia, fibrosis, necrosis)

    Search first: PubMed, Gene Ontology, Reactome

  • Biochemical Abnormalities: Specific molecular defects (enzyme deficiencies, receptor dysfunction, ion channel defects)

    Search first: BRENDA, UniProt, KEGG, OMIM, PubMed

  • Epigenetic Changes: DNA methylation, histone modifications affecting gene expression in disease

    Search first: ENCODE, Roadmap Epigenomics, MethBase, DiseaseMeth

  • Molecular Profiling (if available):
  • Transcriptomics/gene expression changes > Search first: GEO (Gene Expression Omnibus), ArrayExpress, GTEx, Human Cell Atlas, SRA
  • Proteomics findings > Search first: PRIDE, ProteomeXchange, Human Protein Atlas, STRING, BioGRID
  • Metabolomics signatures > Search first: MetaboLights, Metabolomics Workbench, HMDB, METLIN
  • Lipidomics alterations > Search first: LIPID MAPS, SwissLipids, LipidHome, Metabolomics Workbench
  • Genomic structural features > Search first: UCSC Genome Browser, Ensembl, NCBI, dbVar, DGV
  • Advanced Technologies (if applicable):
  • Single-cell analysis findings (cell-type specific mechanisms, cellular heterogeneity) > Search first: Human Cell Atlas, Single Cell Portal, GEO, CELLxGENE
  • Spatial transcriptomics findings > Search first: GEO, Spatial Research, Vizgen, 10x Genomics data
  • Multi-omics integration results > Search first: TCGA, ICGC, cBioPortal, LinkedOmics, PubMed
  • Functional genomics screens (CRISPR, RNAi) > Search first: DepMap, GenomeRNAi, PubMed, BioGRID ORCS

For each mechanism, describe: - The causal chain from initial trigger to clinical manifestation - Which mechanisms are upstream vs downstream - What cell types and biological processes are involved - Suggest GO terms for biological processes and CL terms for cell types

7. Anatomical Structures Affected

  • Organ Level:
  • Primary organs directly affected
  • Secondary organ involvement (complications, secondary effects)
  • Body systems involved (cardiovascular, nervous, digestive, respiratory, endocrine, etc.)

    Search first: Uberon, FMA (Foundational Model of Anatomy), OMIM, HPO, ICD-11, MeSH, SNOMED CT

  • Tissue and Cell Level:
  • Specific tissue types affected (epithelial, connective, muscle, nervous)
  • Specific cell populations targeted (with Cell Ontology terms)

    Search first: Uberon, Human Protein Atlas, Cell Ontology, Human Cell Atlas, CellMarker, PanglaoDB

  • Subcellular Level:
  • Cellular compartments involved (mitochondria, nucleus, ER, lysosomes) (with GO Cellular Component terms)

    Search first: Gene Ontology (Cellular Component), UniProt, Human Protein Atlas

  • Localization:
  • Specific anatomical sites (with UBERON terms) > Search first: FMA, Uberon, NeuroNames (for brain), SNOMED CT
  • Lateralization (unilateral, bilateral, asymmetric) > Search first: HPO, clinical literature, imaging databases

8. Temporal Development

  • Onset:
  • Typical age of onset (congenital, pediatric, adult, geriatric)
  • Onset pattern (acute, subacute, chronic, insidious)

    Search first: OMIM, Orphanet, HPO, PubMed

  • Progression:
  • Disease stages (early, intermediate, advanced, end-stage) > Search first: Cancer Staging Manual (AJCC), WHO classifications, PubMed
  • Progression rate (rapid, slow, variable)
  • Disease course pattern (episodic, relapsing-remitting, progressive, stable)
  • Disease duration (self-limited, chronic lifelong)

    Search first: Disease registries, longitudinal cohort databases, natural history studies, PubMed, Orphanet, OMIM

  • Patterns:
  • Remission patterns (spontaneous, treatment-induced) > Search first: Clinical trial databases, disease registries, PubMed
  • Critical periods (time windows of vulnerability or opportunity for intervention) > Search first: PubMed, developmental biology databases, clinical guidelines

9. Inheritance and Population

  • Epidemiology:
  • Prevalence (cases per 100,000 at given time)
  • Incidence (new cases per 100,000 per year)

    Search first: Orphanet, CDC, WHO, GBD (Global Burden of Disease), national registries, SEER, disease registries

  • For Genetic Etiology:
  • Inheritance pattern (AD, AR, X-linked, mitochondrial, multifactorial, polygenic) > Search first: OMIM, Orphanet, ClinVar, GTR (Genetic Testing Registry)
  • Penetrance (complete, incomplete, age-dependent) > Search first: ClinVar, OMIM, PubMed, ClinGen
  • Expressivity (variable, consistent) > Search first: OMIM, ClinVar, PubMed
  • Genetic anticipation (increasing severity in successive generations) > Search first: OMIM, PubMed (especially for repeat expansion disorders)
  • Germline mosaicism > Search first: ClinVar, OMIM, genetic counseling literature, PubMed
  • Founder effects (population-specific mutations) > Search first: gnomAD, population genetics databases, PubMed
  • Consanguinity role > Search first: OMIM, population studies, genetic counseling resources
  • Carrier frequency > Search first: gnomAD, carrier screening databases, GeneReviews, GTR
  • Population Demographics:
  • Affected populations (ethnic or demographic groups with higher prevalence) > Search first: gnomAD, 1000 Genomes, PAGE Study, PubMed, population registries
  • Geographic distribution (endemic areas, regional variation) > Search first: WHO, CDC, GBD, Orphanet, geographic epidemiology databases
  • Geographic distribution of specific variants
  • Sex ratio (male:female) > Search first: Disease registries, OMIM, PubMed, epidemiological databases
  • Age distribution of affected individuals > Search first: CDC, disease registries, SEER, Orphanet

10. Diagnostics

  • Clinical Tests:
  • Laboratory tests (blood, urine, tissue chemistry, specific enzyme assays) > Search first: LOINC, LabTests Online, PubMed
  • Biomarkers (proteins, metabolites, genetic markers, circulating biomarkers) > Search first: FDA Biomarker List, BEST (Biomarkers, EndpointS, and other Tools), PubMed
  • Imaging studies (X-ray, CT, MRI, PET, ultrasound) > Search first: RadLex, DICOM, Radiopaedia, imaging databases
  • Functional tests (pulmonary function, cardiac stress tests) > Search first: LOINC, clinical guidelines, PubMed
  • Electrophysiology (EEG, EMG, ECG, nerve conduction studies) > Search first: LOINC, clinical neurophysiology databases, PubMed
  • Biopsy findings (histopathology, immunohistochemistry) > Search first: SNOMED CT, College of American Pathologists resources, PubMed
  • Pathology findings (microscopic examination) > Search first: SNOMED CT, Digital Pathology databases, PubMed
  • Genetic Testing:

    Search first: GTR (Genetic Testing Registry), GeneReviews, ClinGen

  • Overview of recommended genetic testing approach
  • Whole genome sequencing (WGS) utility > Search first: GTR, ClinVar, GEL (Genomics England), gnomAD
  • Whole exome sequencing (WES) utility > Search first: GTR, ClinVar, OMIM, GeneMatcher
  • Gene panels (which panels, which genes) > Search first: GTR, ClinVar, laboratory-specific databases
  • Single gene testing > Search first: GTR, ClinVar, OMIM, GeneReviews
  • Chromosomal microarray (CMA) > Search first: DECIPHER, ClinVar, dbVar, ECARUCA
  • Karyotyping > Search first: Chromosome Abnormality Database, ClinVar, cytogenetics resources
  • FISH > Search first: ClinVar, cytogenetics databases, PubMed
  • Mitochondrial DNA testing > Search first: MITOMAP, MSeqDR, ClinVar, GTR
  • Repeat expansion testing > Search first: GTR, ClinVar, repeat expansion databases, PubMed
  • Omics-Based Diagnostics (if applicable):
  • RNA sequencing / transcriptomics > Search first: GEO, ArrayExpress, GTEx, RNA-seq databases
  • Proteomics > Search first: PRIDE, ProteomeXchange, FDA Biomarker database
  • Metabolomics > Search first: MetaboLights, Metabolomics Workbench, HMDB
  • Epigenomics > Search first: GEO, ENCODE, Roadmap Epigenomics, MethBase
  • Liquid biopsy > Search first: COSMIC, ClinVar, liquid biopsy databases, PubMed
  • Clinical Criteria:
  • Standardized diagnostic criteria (DSM, ICD, society guidelines) > Search first: DSM-5, ICD-11, clinical society guidelines, UpToDate
  • Differential diagnosis (other conditions to rule out, with distinguishing features) > Search first: DynaMed, UpToDate, clinical decision support systems
  • Screening:
  • Screening methods for asymptomatic individuals (newborn screening, carrier screening, cascade screening) > Search first: ACMG recommendations, CDC newborn screening, GTR

11. Outcome/Prognosis

  • Survival and Mortality:
  • Survival rate (5-year, 10-year, overall) > Search first: SEER, cancer registries, disease-specific registries, PubMed
  • Life expectancy (with and without treatment if applicable) > Search first: Orphanet, disease registries, actuarial databases, PubMed
  • Mortality rate > Search first: CDC, WHO, GBD, national mortality databases
  • Disease-specific mortality (deaths directly attributable to disease) > Search first: Disease registries, CDC Wonder, GBD, PubMed
  • Morbidity and Function:
  • Morbidity (disease-related disability and health impacts) > Search first: GBD, WHO, disability databases, PubMed
  • Disability outcomes (long-term functional impairments) > Search first: ICF (International Classification of Functioning), disability registries
  • Quality of life measures (EQ-5D, SF-36, PROMIS, disease-specific tools) > Search first: EQ-5D database, SF-36, PROMIS, PubMed
  • Disease Course:
  • Complications (secondary problems: infections, organ failure, etc.) > Search first: ICD codes, disease registries, clinical databases, PubMed
  • Recovery potential (likelihood and extent of recovery, with vs without treatment) > Search first: Natural history studies, rehabilitation databases, PubMed
  • Prediction:
  • Prognostic factors (age, disease severity, biomarkers, treatment response) > Search first: Prognostic models databases, clinical calculators, PubMed
  • Prognostic biomarkers (molecular markers predicting disease course) > Search first: FDA Biomarker database, PubMed, cancer prognostic databases

12. Treatment

  • Pharmacotherapy:
  • Pharmacological treatments (drug names, drug classes, mechanisms of action) > Search first: DrugBank, RxNorm, ATC classification, DailyMed, FDA databases
  • Pharmacogenomics (how genetic variants affect drug metabolism, efficacy, toxicity) > Search first: PharmGKB, CPIC (Clinical Pharmacogenetics), FDA Table of PGx Biomarkers
  • Advanced Therapeutics:
  • Gene therapy (viral vectors, CRISPR, gene replacement, gene editing) > Search first: ClinicalTrials.gov, FDA gene therapy database, ASGCT resources
  • Cell therapy (stem cell transplant, CAR-T, cellular therapeutics) > Search first: ClinicalTrials.gov, FDA cell therapy database, FACT standards
  • RNA-based therapies (ASOs, siRNA, mRNA therapies) > Search first: ClinicalTrials.gov, FDA approvals, PubMed
  • Targeted therapies (treatments directed at specific molecular targets) > Search first: My Cancer Genome, OncoKB, ClinicalTrials.gov, FDA approvals
  • Immunotherapies (checkpoint inhibitors, monoclonal antibodies) > Search first: Cancer Immunotherapy Database, FDA approvals, ClinicalTrials.gov
  • Surgical and Interventional:
  • Surgical interventions (types of surgery, timing, outcomes) > Search first: CPT codes, surgical registries, clinical guidelines, PubMed
  • Supportive and Rehabilitative:
  • Supportive care (symptom management, pain control, nutrition) > Search first: Clinical guidelines, Cochrane Library, PubMed
  • Rehabilitation (physical therapy, occupational therapy, speech therapy) > Search first: Rehabilitation medicine databases, clinical guidelines, PubMed
  • Experimental:
  • Experimental treatments in clinical trials (with NCT identifiers if available) > Search first: ClinicalTrials.gov, EU Clinical Trials Register, WHO ICTRP
  • Treatment Outcomes:
  • Treatment response rates > Search first: Clinical trial databases, FDA reviews, systematic reviews, PubMed
  • Side effects and adverse events > Search first: FDA Adverse Event Reporting System (FAERS), MedWatch, PubMed
  • Treatment Strategy:
  • Treatment algorithms (clinical pathways, decision trees) > Search first: Clinical practice guidelines, NCCN Guidelines, UpToDate
  • Combination therapies > Search first: ClinicalTrials.gov, treatment guidelines, PubMed
  • Personalized medicine approaches (genotype-guided treatment) > Search first: My Cancer Genome, CIViC, PharmGKB, precision medicine databases

For each treatment, suggest MAXO (Medical Action Ontology) terms where applicable.

13. Prevention

  • Prevention Levels:
  • Primary prevention (preventing disease occurrence: vaccination, risk factor modification) > Search first: CDC, WHO, USPSTF recommendations, Cochrane Library
  • Secondary prevention (early detection and treatment: screening programs, early intervention) > Search first: USPSTF, CDC screening guidelines, WHO
  • Tertiary prevention (preventing complications in those with disease) > Search first: Clinical guidelines, disease management protocols, PubMed
  • Immunization: Vaccine strategies (if applicable)

    Search first: CDC vaccine schedules, WHO immunization, FDA vaccine database

  • Screening and Early Detection:
  • Screening programs (population-based: newborn screening, cancer screening) > Search first: CDC screening programs, USPSTF, cancer screening databases
  • Genetic screening (carrier screening, preimplantation genetic diagnosis, prenatal testing) > Search first: ACMG recommendations, ACOG guidelines, GTR
  • Risk stratification (identifying high-risk individuals for targeted prevention) > Search first: Risk prediction models, clinical calculators, PubMed
  • Behavioral Interventions: Lifestyle modifications to reduce risk

    Search first: CDC, WHO, behavioral intervention databases, Cochrane Library

  • Counseling: Genetic counseling (risk assessment, family planning guidance)

    Search first: NSGC resources, ACMG guidelines, GeneReviews

  • Public Health:
  • Public health interventions (sanitation, vector control, health education) > Search first: CDC, WHO, public health databases, PubMed
  • Environmental interventions (reducing environmental risk factors) > Search first: EPA databases, WHO environmental health, PubMed
  • Prophylaxis: Preventive medications or procedures

    Search first: Clinical guidelines, FDA approvals, PubMed

14. Other Species / Natural Disease

  • Taxonomy: Species affected (with NCBI Taxon identifiers)

    Search first: NCBI Taxonomy

  • Breed: Specific breeds affected (with VBO identifiers if applicable)

    Search first: VBO (Vertebrate Breed Ontology)

  • Gene: Orthologous genes in other species (with NCBI Gene IDs)

    Search first: NCBI Gene

  • Natural Disease:
  • Naturally occurring disease in other species (companion animals, wildlife) > Search first: OMIA (Online Mendelian Inheritance in Animals), VetCompass, PubMed
  • Veterinary relevance and importance in animal health > Search first: OMIA, veterinary databases, PubMed
  • Comparative Biology:
  • Comparative pathology (similarities and differences across species) > Search first: OMIA, comparative pathology databases, PubMed
  • Evolutionary conservation of disease mechanisms > Search first: HomoloGene, OrthoMCL, Alliance of Genome Resources
  • Transmission (if applicable):
  • Zoonotic potential > Search first: CDC zoonotic diseases, WHO zoonoses, GIDEON
  • Cross-species susceptibility > Search first: NCBI Taxonomy, veterinary databases, PubMed

15. Model Organisms

  • Model Types:
  • Model organism type (mammalian, invertebrate, cellular, in vitro) > Search first: Alliance of Genome Resources, model organism databases
  • Specific model systems (mouse, rat, zebrafish, Drosophila, C. elegans, yeast, cell lines, organoids, iPSCs) > Search first: MGI, RGD, ZFIN, FlyBase, WormBase, SGD, ATCC, Cellosaurus
  • Induced models (drug treatment, surgical intervention, environmental manipulation) > Search first: MGI, model organism databases, PubMed
  • Genetic Models:
  • Types available (knockout, knock-in, transgenic, conditional, humanized) > Search first: MGI, IMPC, KOMP, EuMMCR, IMSR
  • Model Characteristics:
  • Phenotype recapitulation (how well model reproduces human disease features) > Search first: Model organism databases, comparative studies, PubMed
  • Model limitations (aspects of human disease not captured) > Search first: Model organism databases, PubMed, review articles
  • Applications:
  • Research applications (what aspects of disease can be studied) > Search first: Model organism databases, PubMed
  • Resources:
  • Model databases > Search first: MGI, RGD, ZFIN, FlyBase, WormBase, IMSR, EMMA, MMRRC

Citation Requirements

  • Cite primary literature (PMID preferred) for all mechanistic and clinical claims
  • Prioritize recent reviews and landmark papers
  • Include direct quotes from abstracts where possible to support key statements
  • Distinguish evidence source types: human clinical, model organism, in vitro, computational

Output Format

Structure your response as a comprehensive narrative organized by the sections above. For each section, provide: - Factual content with specific details (numbers, percentages, gene names, variant nomenclature) - Ontology term suggestions (HPO, GO, CL, UBERON, CHEBI, MAXO, MONDO) where applicable - Evidence citations with PMIDs - Direct quotes from abstracts to support key claims - Clear indication when information is not available or not applicable for this disease

This report will be used to populate a disease knowledge base entry with: - Pathophysiology descriptions with causal chains - Gene/protein annotations (HGNC, GO terms) - Phenotype associations (HP terms) with frequencies - Cell type involvement (CL terms) - Anatomical locations (UBERON terms) - Chemical entities (CHEBI terms) - Treatment annotations (MAXO terms) - Evidence items with PMIDs and exact abstract quotes - Epidemiology, prognosis, diagnostic, and prevention information - Animal model descriptions with phenotype recapitulation details

Body Dysmorphic Disorder (BDD) — Disease Characteristics Research Report (Psychiatric)

Date prepared: 2026-04-28
Primary recent anchors: Nature Reviews Disease Primers (Dec 2024) and Psychological Medicine meta-analysis (Dec 2024 online) (ruck2024bodydysmorphicdisorder. pages 1-3, liu2024theefficacyof pages 1-2)

1. Disease information

1.1 Concise overview (current understanding)

Body dysmorphic disorder (BDD) is an obsessive–compulsive and related disorder characterized by an intense, persistent preoccupation with perceived defects or flaws in physical appearance that are not observable (or are only slight) to others, accompanied by repetitive behaviors or mental acts (e.g., checking, camouflaging, comparing) and associated distress/impairment (ruck2024bodydysmorphicdisorder. pages 1-3, ruck2024bodydysmorphicdisorder. pages 9-11).

1.2 Key identifiers and classification

  • ICD-11 code: 6B21 Body dysmorphic disorder (explicitly identified and defined in the ICD-11 OCRD grouping) (sjogren2019thediagnosticworkup pages 2-4, sjogren2019thediagnosticworkupa pages 2-4).
  • Verbatim ICD-11 essential-feature description (as reproduced in Sjögren 2019): persistent preoccupation with perceived defects (unnoticeable or slight to others), excessive self-consciousness often with ideas of reference, and repetitive/excessive behaviors (repeated examination, camouflaging/alteration attempts, or marked avoidance) that cause significant distress or impairment (sjogren2019thediagnosticworkupa pages 2-4).
  • DSM-5 / DSM-5-TR context: BDD is placed in Obsessive-Compulsive and Related Disorders and includes an insight specifier and a muscle dysmorphia specifier (ruck2024bodydysmorphicdisorder. pages 9-11).
  • Other identifiers requested (MONDO, MeSH, OMIM, Orphanet): not retrievable from the tool-sourced evidence corpus used here; therefore not asserted.

1.3 Common synonyms / alternative names

  • Body dysmorphia (colloquial; not a formal diagnosis in ICD/DSM) (loewen2024prevalenceofbody pages 1-2).
  • Muscle dysmorphia (DSM specifier; often conceptualized as a BDD specifier/subtype) (ruck2024bodydysmorphicdisorder. pages 9-11).

1.4 Evidence-source type

Information in this report is derived from aggregated disease-level resources (e.g., Nature Reviews Disease Primers), systematic reviews/meta-analyses, and primary human studies (population surveys, RCTs, fMRI studies), rather than individual EHR-only case series (ruck2024bodydysmorphicdisorder. pages 1-3, liu2024theefficacyof pages 1-2).

2. Etiology

2.1 Disease causal factors (multifactorial)

BDD etiology is described as an interplay of genetic and environmental factors, with comparatively limited biological research versus other OCRDs (ruck2024bodydysmorphicdisorder. pages 1-3, ruck2024bodydysmorphicdisorder. pages 3-4).

2.2 Risk factors

Genetic liability - Twin studies suggest heritability ~37–49% for BDD-related phenotypes, consistent with partial genetic liability (ruck2024bodydysmorphicdisorder. pages 3-4). - A key knowledge gap is that no BDD GWAS exists yet, limiting locus-level inference (ruck2024bodydysmorphicdisorder. pages 3-4).

Environmental / psychosocial risk - Environmental stressors implicated include bullying and childhood trauma, consistent with diathesis–stress models (ruck2024bodydysmorphicdisorder. pages 3-4).

2.3 Protective factors

No specific genetic or environmental protective factors were identified in the retrieved evidence; thus this remains insufficiently characterized in this report.

2.4 Gene–environment interactions

No explicit GxE interaction studies were identified in the retrieved evidence; thus not currently characterizable here.

3. Phenotypes (clinical presentation)

3.1 Core symptoms and behaviors (with frequency data when available)

Core phenotype: appearance-related preoccupation, self-focused attention/ideas of reference, repetitive behaviors/mental acts, avoidance, and impaired insight (ruck2024bodydysmorphicdisorder. pages 9-11, sjogren2019thediagnosticworkupa pages 2-4).

Common body areas of preoccupation (ranges across samples): - Skin 50–92%, hair 47–64%, nose 33–64%, face 27–64%, teeth 30–51%, weight 29–51%, stomach 23–53%, eyes 20–43%, thighs 17–42% (ruck2024bodydysmorphicdisorder. pages 32-33).

Common repetitive behaviors (prevalence ranges across samples): - Comparing with others 87–97%, mirror checking 85–92%, camouflaging 70–94%, grooming 59–72%, reassurance seeking 53–73%, applying make-up 51–65%, touching body areas 47–59%, distraction techniques 45–55%, clothes changing 44–56% (ruck2024bodydysmorphicdisorder. pages 32-33).

Time burden - BDD thoughts/behaviors are described as time-consuming, averaging about 3–8 hours/day in one clinical overview source (champlain2015bodydysmorphicdisorder pages 108-111).

Insight/delusionality - Insight is on a continuum from good to absent (delusional conviction); poor/absent insight can impede help-seeking (ruck2024bodydysmorphicdisorder. pages 9-11, sjogren2019thediagnosticworkup pages 4-5).

3.2 Age of onset, severity, and progression

  • Onset is typically before age 18 in ~two-thirds of cases (ruck2024bodydysmorphicdisorder. pages 1-3, ruck2024bodydysmorphicdisorder. pages 3-4).
  • A population-survey summary in Spain reports mean age of onset 16.9 years (and in their web sample, mean age of participants meeting BDD criteria was 23.5 years) (loewen2024prevalenceofbody pages 1-2).

3.3 Functional impact / quality of life

BDD can lead to profound social/educational/occupational impairment (including isolation/housebound behavior) (ruck2024bodydysmorphicdisorder. pages 9-11). A large impairment signal is also reflected by proportions not working (36%) or not in school (32%) in cited clinical cohorts (ruck2024bodydysmorphicdisorder. pages 14-16).

3.4 Suggested HPO terms (examples)

(Ontology suggestions; exact mapping should be validated against HPO) - Preoccupation/obsessional thoughts: Obsessive thoughts (HP:0000722) - Compulsions/repetitive behaviors: Compulsive behavior (HP:0008763) - Avoidance: Social withdrawal (HP:0000740) - Poor insight/delusional conviction: Delusions (HP:0000746) - Anxiety/depression commonly comorbid: Anxiety (HP:0000739); Depression (HP:0000716)

4. Genetic / molecular information

4.1 Causal genes and pathogenic variants

BDD is not currently characterized as a monogenic disorder, and the retrieved evidence does not support specific causal genes/variants (ruck2024bodydysmorphicdisorder. pages 3-4).

4.2 Polygenic liability

  • Twin-based heritability estimates support polygenic liability (37–49%), but gene discovery is limited and GWAS is absent in the cited primer (ruck2024bodydysmorphicdisorder. pages 3-4).

4.3 Epigenetics / chromosomal abnormalities

No BDD-specific epigenetic or chromosomal-abnormality evidence was retrieved.

5. Environmental information

BDD risk appears influenced by psychosocial exposures (e.g., bullying/trauma) and sociocultural appearance pressures; the retrieved evidence supports bullying/trauma as relevant stressors but does not provide toxin/radiation/infectious triggers (ruck2024bodydysmorphicdisorder. pages 3-4).

6. Mechanism / pathophysiology

6.1 Conceptual causal chain (integrated model)

A working model supported by the 2024 primer and human neuroimaging studies is that genetic liability + adverse developmental/social experiences predispose to cognitive-affective and perceptual processing alterations (e.g., attention biases, aberrant visual processing of faces/bodies). These alterations contribute to persistent appearance-related preoccupations, compulsions/avoidance, and functional impairment; poor insight and ideas of reference can maintain the cycle and delay care (ruck2024bodydysmorphicdisorder. pages 3-4, ruck2024bodydysmorphicdisorder. pages 9-11).

6.2 Visual processing and attention circuitry (human neuroimaging)

  • A mechanistic fMRI + eye-tracking experiment in 37 unmedicated adults with BDD and 30 controls tested “visual-attention modification” (fixating gaze at the image center while viewing one’s face). The study reports that modulated viewing increased fixation duration and strengthened connectivity from occipital to parietal dorsal visual stream regions in BDD, with persistence into subsequent natural viewing (wong2022neuralandbehavioral pages 1-2). The authors conclude that holding gaze may increase dorsal stream communication and “facilitating global/holistic visual processing,” relevant to perceptual retraining approaches (wong2022neuralandbehavioral pages 1-2).

6.3 Serotonergic mechanisms and novel interventions (translational/experimental)

  • An open-label neuroimaging study administered single-dose psilocybin (25 mg) with psychological support to 8 adults with moderate-to-severe nondelusional BDD and found BDD-YBOCS decreases at week 1 and week 12 (p<0.001), with rs-fMRI connectivity changes (ECN and ECN–DMN/Salience links) predicting week-1 improvement; authors emphasize the small sample and uncontrolled design (zhu2024singledosepsilocybinalters pages 1-3).

6.4 Suggested GO biological process terms (examples)

(Ontology suggestions; validate in GO) - Visual perception; attention; response to serotonin; fear response; learning.

6.5 Suggested CL cell types (examples)

Neural circuitry models implicate cortical and limbic systems; plausible CL terms include cortical pyramidal neuron and GABAergic interneuron (conceptual; not directly evidenced in retrieved texts).

7. Anatomical structures affected

BDD is psychiatric/behavioral but implicates brain systems involved in visual, attentional, and emotional processing.

7.1 Organ/system level (UBERON suggestions)

  • Brain (UBERON:0000955), including cerebral cortex (UBERON:0000956) and visual cortex (UBERON term selection dependent on knowledge-base conventions).

7.2 Tissue/cell and subcellular levels

No disease-specific tissue pathology or subcellular lesions are described in the retrieved evidence; abnormalities are primarily functional-network level (wong2022neuralandbehavioral pages 1-2, zhu2024singledosepsilocybinalters pages 1-3).

8. Temporal development

8.1 Onset and course

BDD typically begins in adolescence (two-thirds before 18), and can become chronic with substantial impairment if untreated (ruck2024bodydysmorphicdisorder. pages 1-3, ruck2024bodydysmorphicdisorder. pages 3-4).

8.2 Remission patterns

  • CBT gains may be maintained up to 4 years in follow-up studies cited in the primer (ruck2024bodydysmorphicdisorder. pages 12-14).
  • SSRI continuation reduces relapse in an escitalopram relapse-prevention trial (18% relapse on continued escitalopram vs 40% on placebo over 6 months) (ruck2024bodydysmorphicdisorder. pages 12-14).

9. Inheritance and population

9.1 Epidemiology (recent quantitative data)

  • General adult prevalence (high-income countries): ~2% (ruck2024bodydysmorphicdisorder. pages 1-3).
  • Children <12: ~0.1%; adolescents: ~1.9%, with adolescent girls 3.4% vs boys 0.4% (ruck2024bodydysmorphicdisorder. pages 3-4).
  • Clinical settings (approximate): ~7% inpatient psychiatry, 13% cosmetic surgery, 11% dermatology (ruck2024bodydysmorphicdisorder. pages 3-4).
  • Plastic/reconstructive surgery populations (meta-analysis, 65 studies; n=17,107): 18.6% (kaleeny2024bodydysmorphicdisorder pages 12-14).
  • Spain web-based survey (Jan 2024, n=2091): 15.2% met BDDQ criteria, with higher proportions in women and students; interpretation should consider sampling and survey methodology (loewen2024prevalenceofbody pages 1-2).

9.2 Sex ratio and age distribution

  • Female preponderance appears stronger in youth; adult sex differences are described as smaller in the primer (ruck2024bodydysmorphicdisorder. pages 3-4).

9.3 Comorbidity (visual evidence)

The primer reports high psychiatric comorbidity; Figure 1 in the primer summarizes comorbidity prevalence patterns in adults vs young people (ruck2024bodydysmorphicdisorder. media f77f1d9b).

10. Diagnostics

10.1 Clinical criteria (ICD-11/DSM framing)

Diagnosis requires: appearance preoccupation + repetitive behaviors/mental acts and associated distress/impairment; eating-disorder explanations should be excluded (ruck2024bodydysmorphicdisorder. pages 9-11, sjogren2019thediagnosticworkupa pages 2-4).

10.2 Screening and diagnostic instruments

  • Brief screening tools: BDDQ; COPS (cosmetic procedure screening) (ruck2024bodydysmorphicdisorder. pages 11-12). Dermatology/cosmetic variants include BDDQ-DV and DCQ (sjogren2019thediagnosticworkupa pages 2-4).
  • Structured/semi-structured diagnostic interviews: BDD Module; DIAMOND; SCID BDD module referenced in diagnostic work-up literature (ruck2024bodydysmorphicdisorder. pages 11-12, sjogren2019thediagnosticworkupa pages 2-4).
  • Severity scales: clinician-rated BDD-YBOCS and BDD-YBOCS-A (ruck2024bodydysmorphicdisorder. pages 11-12).
  • Response definition: ≥30% reduction in BDD-YBOCS/BDD-YBOCS-A (ruck2024bodydysmorphicdisorder. pages 11-12).
  • Partial/full remission: BDD-YBOCS ≤16 (ruck2024bodydysmorphicdisorder. pages 11-12).
  • No laboratory tests are required/used diagnostically in the diagnostic work-up review (sjogren2019thediagnosticworkupa pages 2-4).

10.3 Differential diagnosis (examples)

Differentials include eating disorders (shape/weight focus), OCD, psychotic disorders, social anxiety disorder, trichotillomania/excoriation disorder, gender dysphoria, and other OCRDs; careful assessment of insight and symptom focus is emphasized (sjogren2019thediagnosticworkup pages 4-5, ruck2024bodydysmorphicdisorder. pages 9-11).

11. Outcome / prognosis

11.1 Suicidality and mortality risk

  • Lifetime suicide attempt prevalence is reported as 10–35% in the 2024 primer synthesis (ruck2024bodydysmorphicdisorder. pages 3-4).
  • A Swedish population-based study cited in the primer found increased suicide risk: HR 3.47 (95% CI 1.76–6.85) (ruck2024bodydysmorphicdisorder. pages 3-4).

11.2 Morbidity and disability

BDD is associated with marked quality-of-life impairment and functional disability, including occupational and educational non-participation (ruck2024bodydysmorphicdisorder. pages 14-16).

12. Treatment

12.1 Evidence-based first-line treatments

Cognitive behavioral therapy (CBT), tailored for BDD - The 2024 primer describes CBT as the most evidence-based psychotherapy; a meta-analysis of seven RCTs found a large effect (d = −1.22) (ruck2024bodydysmorphicdisorder. pages 12-14). - Response rates (≥30% BDD-YBOCS reduction) range ~40–82% (ruck2024bodydysmorphicdisorder. pages 12-14). - Core components include psychoeducation, formulation, exposure with response prevention, behavioral experiments, cognitive restructuring, plus techniques like mirror retraining/imagery rescripting/self-compassion (ruck2024bodydysmorphicdisorder. pages 12-14).

Digital/Internet CBT (implementation-relevant) - Digital CBT shows sizable effects (e.g., d = 1.44 vs waitlist; d = 0.95 vs supportive therapy) with relatively low therapist input, supporting scalability (ruck2024bodydysmorphicdisorder. pages 12-14). - A 2024 meta-analysis across 15 RCTs found that mode of delivery (face-to-face vs digital) did not significantly moderate outcomes, and pooled effects improved BDD symptoms (g = −0.97) and QoL (g = 0.44) (liu2024theefficacyof pages 1-2).

Selective serotonin reuptake inhibitors (SSRIs) - SSRIs (fluoxetine, sertraline, escitalopram) are first-line pharmacotherapy; RCTs show response rates 53–65% vs 18–35% in control groups (ruck2024bodydysmorphicdisorder. pages 12-14). - Relapse prevention: continued escitalopram reduced relapse (18% vs 40% over 6 months) (ruck2024bodydysmorphicdisorder. pages 12-14).

12.2 Augmentation and non-first-line options

  • Evidence for antipsychotic augmentation is limited; one RCT found pimozide augmentation of fluoxetine was not better than placebo (response rates ~18% in both arms) (ruck2024bodydysmorphicdisorder. pages 14-16).

12.3 Experimental/novel therapeutics

  • Psilocybin open-label trial with neuroimaging suggests symptom improvements with network-level predictors, but requires larger controlled trials (zhu2024singledosepsilocybinalters pages 1-3).

12.4 Real-world implementation and applications

  • High BDD prevalence in cosmetic/plastic surgery settings motivates routine preoperative screening and multidisciplinary care, with the 2024 plastic-surgery meta-analysis highlighting screening needs and prevalence (18.6%) (kaleeny2024bodydysmorphicdisorder pages 12-14).
  • The 2024 primer notes barriers to evidence-based care: poor insight, cosmetic-procedure seeking, stigma, scarcity of trained CBT therapists, and limited dissemination outside specialist centers (ruck2024bodydysmorphicdisorder. pages 12-14).

12.5 Suggested MAXO terms (examples)

(Ontology suggestions; validate in MAXO) - Cognitive behavioral therapy; Exposure and response prevention; Selective serotonin reuptake inhibitor therapy; Internet-based psychotherapy; Suicide risk assessment.

13. Prevention

Evidence-based prevention strategies are described as lacking; the primer emphasizes need for early detection and dissemination of effective treatments rather than established primary prevention programs (ruck2024bodydysmorphicdisorder. pages 11-12, ruck2024bodydysmorphicdisorder. pages 12-14).

14. Other species / natural disease

No validated naturally occurring BDD analogs in other species were identified in the retrieved evidence.

15. Model organisms

No model-organism systems were identified in the retrieved evidence. Current mechanistic work is largely human (neuroimaging/behavioral) (wong2022neuralandbehavioral pages 1-2, zhu2024singledosepsilocybinalters pages 1-3).

Key quantitative snapshot (2023–2024–anchored)

Domain Statistic Population/Setting Notes/Definition Source
Epidemiology ~2% point prevalence General adult population in high-income countries Community-based adult prevalence estimate Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 1-3, ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 0.1% Children aged <12 years Youth prevalence reported as low before adolescence Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 1.9% Adolescents Prevalence rises in adolescence Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 3.4% vs 0.4% Adolescent girls vs boys Female preponderance in youth Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology ~7% Inpatient psychiatry settings Clinical setting prevalence higher than community prevalence Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 13% Cosmetic surgery settings Approximate prevalence in cosmetic surgery clinics Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 11% Dermatology settings Approximate prevalence in dermatology clinics Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Epidemiology 18.6% Aesthetic and reconstructive plastic surgery populations Meta-analysis of 65 studies; 17,107 patients Kaleeny & Janis, 2024 (kaleeny2024bodydysmorphicdisorder pages 12-14)
Suicidality 10–35% Individuals with BDD Lifetime suicide attempt prevalence across studies Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Suicidality HR 3.47 (95% CI 1.76–6.85) Swedish population-level cohort >3-fold increased risk of death by suicide Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 3-4)
Psychotherapy d = -1.22 CBT for BDD Meta-analysis of 7 RCTs found a large effect on BDD symptoms Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 12-14)
Psychotherapy 40–82% response CBT-treated BDD samples Response commonly defined as >=30% reduction on BDD-YBOCS Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 12-14, ruck2024bodydysmorphicdisorder. pages 11-12)
Psychotherapy d = 1.44 vs waitlist; d = 0.95 vs supportive therapy Digitalized CBT Evidence suggests benefit comparable to face-to-face formats Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 12-14)
Psychotherapy g = -0.97 Psychological treatments across 15 RCTs (n=905) Meta-analysis: improvement in BDD symptoms; benefits sustained 1–6 months Liu et al., 2024 (liu2024theefficacyof pages 1-2)
Pharmacotherapy 53–65% vs 18–35% SSRI trials vs controls First-line SSRIs include fluoxetine, sertraline, escitalopram Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 12-14)
Pharmacotherapy 18% vs 40% relapse over 6 months Escitalopram responders continuing SSRI vs placebo Continuation treatment reduced relapse Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 12-14, ruck2024bodydysmorphicdisorder. pages 14-16)
Functional impact 36% not working; 32% not in school Individuals with BDD Indicates substantial occupational/educational impairment Rück et al., 2024 (ruck2024bodydysmorphicdisorder. pages 14-16)

Table: This table summarizes key epidemiologic, suicidality, treatment-response, and functional-impact statistics for body dysmorphic disorder from the gathered evidence. It is useful as a compact evidence snapshot for clinical or knowledge-base reporting.

Visual evidence (comorbidity patterns)

Figure 1 from the 2024 Nature Reviews Disease Primers article provides a visual summary of psychiatric comorbidity prevalence in adults vs young people with BDD (ruck2024bodydysmorphicdisorder. media f77f1d9b).

Reference URLs and publication dates (from retrieved sources)

  • Rück C, Mataix-Cols D, Feusner JD, et al. Body dysmorphic disorder. Nature Reviews Disease Primers. Dec 2024. https://doi.org/10.1038/s41572-024-00577-z (ruck2024bodydysmorphicdisorder. pages 1-3)
  • Liu Y, Lai L, Wilhelm S, Phillips KA, et al. The efficacy of psychological treatments on body dysmorphic disorder: a meta-analysis and trial sequential analysis of randomized controlled trials. Psychological Medicine. First published online 03 Dec 2024. https://doi.org/10.1017/S0033291724002733 (liu2024theefficacyof pages 1-2)
  • Loewen Á, Blasco-Fontecilla H, Li C, et al. Prevalence of Body Dysmorphic Disorder in the Spanish Population: Cross-Sectional Web-Based Questionnaire Study. JMIR Formative Research. Jan 2024. https://doi.org/10.2196/46515 (loewen2024prevalenceofbody pages 1-2)
  • Kaleeny JD, Janis JE. Body Dysmorphic Disorder in Aesthetic and Reconstructive Plastic Surgery—A Systematic Review and Meta-Analysis. Healthcare (Basel). Jul 2024. https://doi.org/10.3390/healthcare12131333 (kaleeny2024bodydysmorphicdisorder pages 12-14)
  • Wong W-W, Rangaprakash D, Diaz-Fong JP, et al. Neural and behavioral effects of modification of visual attention in body dysmorphic disorder. Translational Psychiatry. Aug 2022. https://doi.org/10.1038/s41398-022-02099-2 (wong2022neuralandbehavioral pages 1-2)
  • Zhu X, Zhang C, Hellerstein D, et al. Single-dose psilocybin alters resting state functional networks in patients with body dysmorphic disorder. Psychedelics (NY). Published in final form 2025 (study reports trial ID NCT04656301). https://doi.org/10.61373/pp024r.0028 (zhu2024singledosepsilocybinalters pages 1-3)

References

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