Psychology and Psychiatry


Dysmorphophobia - This is a mental disorder in which the subject is extremely concerned about small defects or some features of his own body. This disorder usually begins in adolescence. Dysmorphophobia affects all people, regardless of gender difference. The main danger of dysmorphophobia are suicidal attempts.

Dysmorphophobia is a pathological belief and belief in the presence of any physical defects or diseases, which is based on somatic sensations leading to hypochondria. It includes three main components: the belief in the presence of physical "deformity" (deficiency), which can be real or exist only in the patient's ideas, ideas of attitude, depressive states.

Dysmorphophobia causes

Most often, dysmorphophobia syndrome is formed in adolescence due to the fact that their own appearance for them becomes the first place. There are biological, psychological, social and personal factors that cause dysmorphophobia.

Biological factors include metabolic disorders of neurotransmitters, obsessive-compulsive syndrome, genetic predisposition, generalized anxiety disorder, possible developmental anomalies of certain brain regions and information processing using vision.

The psychological reasons for the appearance of dysmorphophobia are due to the fact that the adolescent is often teased or criticized. The result of the research is the determination that 60% of the subjects were criticized or regularly teased in childhood. Also psychological factors include the manner of education. If the parents of the child focus the child’s attention on the aesthetic appearance of the personality, then this may serve as a trigger for persons with a genetic predisposition. In cases where adolescents do not have enough love and affection, they begin to think that they are not loved because of their external unattractiveness or any defects. Another such trigger can be such factors as neglect or neglect, previously suffered physical or sexual trauma.

Social factors usually include the negative impact of the media. This is due to the standard of beauty adopted today and its widespread advertising on television and other places of mass distribution of information.

Some traits can also make possible the development of dysmorphophobia. Such traits are concomitant factors. Such features of character include self-doubt, timidity, neurotic states or neurosis, hypersensitivity to criticism, introversion, perfectionism.

Dysmorphophobia symptoms

There are many symptoms of dysmorphophobia. For the most part, the symptoms of dysmorphophobia are determined by seemingly external unattractiveness or any defects.

Patients with dysmorphobia constantly look at themselves in the mirror or other surfaces displaying the exterior, while trying to find a more favorable angle, in which the seeming flaw will not be visible, and understand how to mask it.

Dysmorphophobia sufferers flatly refuse to be photographed. The pretexts for such a refusal may be completely different. However, the real reason for the refusal will be the fear that with the help of a photograph their deformity will be perpetuated. With this symptom, patients more often refuse to look at themselves in the mirror-reflecting surface.

The main symptoms of dysmorphophobia syndrome are as follows:

- attempts to hide apparent defects, for example, using baggy clothes;

- excessive care for their own appearance;

- obsessive touching the skin to feel the apparent defect;

- asking relatives about the defect;

- excessive enthusiasm for exercise and diet;

- social deprivation;

- low self-esteem;

- refusal to leave the house or leave only at night, when no one can notice the alleged "deformity";

- decrease in educational activity;

- communication problems;

- abuse of alcohol or drugs (self-treatment attempts);

- Anxiety and exposure to panic attacks;

- depressive states;

- suicidal mood;

- loneliness and social isolation;

- dependence on others;

- inability to work;

- the inability to focus on working moments due to sustained preoccupation with their appearance;

- a feeling of awkwardness in society, suspicion that others discuss the apparent defect;

- comparing themselves and their individual parts of the body with the standards of beauty, idols, indicating to others;

- using methods of distracting the attention of others, for example, an extravagant appearance that allows you to hide flimsy defects;

- intrusive search for information related to deficiencies and defects, for example, excess weight and diet to get rid of it;

- the desire to correct an artificial defect with the help of plastic surgery, the transfer of repeated plastic surgeries that do not bring satisfaction;

- attempts to remove the defect on its own, for example, cutting with a knife.

Summing up, we can conclude that, in the main, dysmorphophobia is more susceptible to young subjects in the puberty period between the ages of 13 and 20 years. Pubertal dismorphobia has one common symptom - preoccupation with imaginary physical defects. Most adolescents are concerned about the state of their epidermis, the shape of the nose, excessive hair growth throughout the body and not enough on the head, etc.

If you do not immediately identify dysmorphophobia, then further excessive concern develops into anxiety. Teenagers are constantly under stress due to contrived deficiencies.

Dysmorphophobia in adolescents

Dysmorfomania is peculiar to pubertal age, when all adolescents increase their attention to their own appearance and increase the desire to bring it to a fictitious standard. Therefore, in adolescence, hypertrophied sharpening of what is already embedded in the human psyche is often noted. Sometimes dysmorfomania happens in a very severe form, but most often it occurs as borders of borderline disorders and with correct treatment, there is not a trace of the disease. In adult subjects, dysmorfomania occurs very rarely, and most often it is a consequence of a disease that has not been previously treated as a teenager.

The syndrome of dysmorphophobia due to the peculiarities of its psychopathological structure can be attributed to either hypochondria or delusional or obsessive or overvalued disorders.

Puberous dysmorphophobia is based on phobias, which necessarily have an obsessive and overvalued character. Its main feature is that adolescents suffering from this disease are pathologically convinced or have any physical defect (lack) in themselves, or in the distribution of an unpleasant odor. At the same time, all patients have a strong fear that others see such shortcomings, collectively discuss them and laugh at them.

Dysmorphophobia syndrome in adolescents is characterized by the following triad of symptoms: the overvalued idea of ​​a physical defect, the idea of ​​a relationship, and depression (depressed mood). In cases where the adolescent's fear is the spread of an unpleasant odor, adolescent dysmorphophobia is characterized by bodily sensations and olfactory deceptions of perception.

Adolescents suffering from dysmorphophobia often cover their painful excitement (dissimulation). In this regard, it is important to know the specific manifestations that can be found in young people, who will testify to the painful background of fears. Such symptoms of dysmorphophobia include the symptom of a mirror, which consists in constantly examining oneself in a mirror in order to verify the presence or absence of deficiencies and to find the desired turn of the face or body that will conceal the contrived defects. Such children always carry a mirror with them, requiring it to hang everywhere in order to always see themselves. Another symptom is the symptom of "photography", which is the persistent unwillingness to take pictures, hide their photos so that no one person can see them and fix their own guesses about the presence of "deformity" in a teenager.

Pubertal dismorphobia more often occurs in children with personal accentuation of character in a sensory-schizoid, hysterical, or anxiety-suspicious type. It is a psychogenically provoked reaction that arises as a result of the corresponding observations of the interlocutors. In the case of mild dysmorphophobia, disorders are partial, partial, not reducing performance, academic performance, can only be found in situations that are particularly significant for dysmorphophobia, for example, in large companies, before important meetings, with a strong desire to please. With growing up, such manifestations can be smoothed out without additional treatment, independently. However, they may acquire a more severe and prolonged nature (dysmorfomania).

Dysmorphomania is considered to be a delusional variant of adolescent dysmorphophobia, which can occur in low-grade schizophrenia. This option is dangerous because it may be the basis for the appearance of anorexia. Over time, tedious war with far-fetched defects becomes almost the main goal of life, its main focus and meaningful content. In this case, there is a tendency to increase the area of ​​dysmorphic experiences. Personality changes become more pronounced: vulnerability in combination with coldness, persistence of anxious depressive states in conjunction with suicidal tendencies, sensitizing delusional manifestations - all this only worsens the condition of adolescents. It seems to patients that absolutely everyone is focused on them, they notice shortcomings, they make insulting hints related to imaginary defects. If the disease is not treated, then further such experiences will be accompanied by thoughts about the incurability of the defect and the presence of any degrading diseases.

Dysmorphophobia treatment

Treatment of dysmorphophobia should be symptomatic. This means that during clearly expressed emotionally-stressed states or when the depressive background of the condition is enhanced, antidepressants and tranquilizers are prescribed, for example, Tazepam. The psychotherapeutic effect aimed at dissuading is completely ineffective. The psychotherapist has a completely different task. Its purpose is to attempt to induce the patient to be humble with his appearance, with an exaggerated or imaginary flaw. The psychotherapist must teach the patient with dysmorphophobia to hide his unhealthy experiences from other people - to achieve compensatory dissimulation.

Strongly recommended all sorts of plastic surgery. Not only will they not eliminate dysmorphobic feelings, but they can also lead to a completely opposite result, i.e. The condition of the patient with dysmorphophobia worsens even more. If dysmorphophobia is caused by schizophrenia, then the underlying disease should be treated.

Numerous studies have shown that psychodynamic therapy models do not benefit from dysmorphophobia. But the use of cognitive-behavioral psychotherapy is more successful.

Sometimes, with a mild course of the disease, it will be effective to communicate about their apparent deformities with a significant and authoritative person. You can also offer the patient not to hide his defect, however, along with this, you need to make him feel confident that the doctor is on his side. If the patient is tormented by apparent defects localized on the face, then in this case it is recommended to refuse to apply makeup. The patient needs to be forced to transform his value system, reorient it to something else.

In the most severe cases, when the risk of suicidal attempts and severe depressive states is high, hospitalization is recommended.