Patients with body dysmorphic disorder need risk assessment

Editor - After reading last month's article about body dysmorphic disorder,¹ I felt that a few important points needed to be raised. The first is that the actual strength of the belief in the deformity is key to understanding the nature of the diagnosis and the effect it may have on the patient's life. It is important to assess whether the belief is delusional, overvalued, or obsessional, as these all have diagnostic significance. The second point is that these patients require a thorough risk assessment. I recently saw a patient who was actively suicidal because of his perceived jaw deformity. Also, some patients are so desperate to correct perceived deformities that they may resort to trying to correct them themselves, with obvious horrific consequences.

LAURENT REBOURS/AP

1. Clausen Body dysmorphic disorder: through a glass darkly. studentBMJ 2005;13:144-5. (April.)