Körperdysmorphe Störung
Abstract
Bei der Körperdysmorphen Störung (KDS) handelt es sich mit einer Punktprävalenz von 0.7–2.4 % um ein relativ häufiges Störungsbild. Kennzeichnend für die Erkrankung ist die übermäßige Beschäftigung mit einem vermeintlichen oder geringfügigen Makel des eigenen äußeren Erscheinungsbilds. Der Krankheitsbeginn liegt in der Regel im Jugendalter. Die KDS ist mit hohen Komorbiditätsraten und erhöhter Suizidalität assoziiert, oftmals zeigt sich ein chronischer Verlauf. Entsprechend des derzeitigen Kenntnisstandes kommen die kognitiv-behaviorale Therapie und die Pharmakotherapie mit selektiven Serotoninwiederaufnahme-Inhibitoren als therapeutische Optionen in Betracht. Die Kasuistik schildert einen aktuellen KDS-Fall mit typischer klinischer Symptomatik und typischem Therapieverlauf. Das Ziel dieser selektiven Übersichtsarbeit ist es, das Bewusstsein für die Erkrankung in der kinder- und jugendpsychiatrischen Praxis zu stärken, um eine adäquate Diagnosestellung und Therapie von Kindern und Jugendlichen mit KDS zu ermöglichen.
Body dysmorphic disorder (BDD) is a relatively common disorder with a point prevalence of 0.7–2.4 %. BDD is characterized by the patient’s excessive concern with an imagined or slight defect in physical appearance. BDD usually begins in adolescence. Comorbidity rates and also suicidality rates are high. The course of BDD tends to be chronic. According to the present state of knowledge, cognitive-behavioral therapy and pharmacotherapy with selective serotonin reuptake inhibitors are valuable options in the therapy of BDD. The case report describes a recent case of BDD with typical clinical and therapy-related characteristics. The aim of this work is to strengthen the awareness of BDD in clinical practice of child and adolescent psychiatry, facilitating an adequate diagnosis and treatment of the affected individuals.
Literatur
(1999). Thirty-three cases of body dysmorphic disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 453–459.
(2008). Intensive cognitive-behavioral therapy for adolescents with body dysmorphic disorder. Clinical Case Studies, 8, 113–121.
(2008). An open-label trial of venlafaxine in body dysmorphic disorder. CNS spectrums, 13, 138–144.
(2013). Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-5). Arlington, VA: American Psychiatric Association.
(2010). Brain morphology of patients with body dysmorphic disorder. Journal of affective disorders, 123, 258–263.
(2013). Age at onset and clinical correlates in body dysmorphic disorder. Comprehensive Psychiatry, 54, 893–903.
(2002). Prevalence of body dysmorphic disorder in a German college student sample. Psychiatry Research, 109, 101–104.
(2010). Updates on the prevalence of body dysmorphic disorder: A population-based survey. Psychiatry Research, 178, 171–175.
(2005). Nonpsychiatric medical treatment of body dysmorphic disorder. Psychosomatics, 46, 549–555.
(1997). Epidemiology of somatoform disorders: A community survey in Florence. Social Psychiatry and Psychiatric Epidemiology, 32, 24–29.
(2007). Visual information processing of faces in body dysmorphic disorder. Archives of General Psychiatry, 64, 1417–1425.
(2009). Regional brain volumes and symptom severity in body dysmorphic disorder. Psychiatry Research, 172, 161–167.
(2006). Pathological skin picking in individuals with body dysmorphic disorder. General Hospital Psychiatry, 28, 487–493.
(2010). Cognitive-behavioral therapy for adolescent body dysmorphic disorder. Cognitive and Behavioral Practice, 17, 248–258.
(2003). Axis I comorbidity in body dysmorphic disorder. Comprehensive Psychiatry, 44, 270–276.
(1999). Clomipramine vs desipramine crossover trial in body dysmorphic disorder: selective efficacy of a serotonin reuptake inhibitor in imagined ugliness. Archives of General Psychiatry, 56, 1033–1039.
(2002). Body dysmorphic disorder in an adolescent girl. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1503–1509.
(2009). Pharmacotherapy and psychotherapy for body dysmorphic disorder. The Cochrane Database of Systematic Reviews, (1), CD005332.
(2008). The prevalence of body dysmorphic disorder in the United States adult population. CNS Spectrums, 13, 316–322.
(2012). Cognitive behaviour therapy for adolescents with body dysmorphic disorder: A case series. Behavioural and cognitive psychotherapy, 40, 452–461.
(2010). Delusional versus nondelusional body dysmorphic disorder. Comprehensive psychiatry, 51, 177–182.
(2009). The temperament and character profile of a body dysmorphic disorder outpatient sample. Personality and Mental Health, 3, 284–294.
(2012). A twin study of body dysmorphic concerns. Psychological Medicine, 42, 1949– 1955.
(1996). Effect of cognitive behavioral therapy on persons with body dysmorphic disorder and axis ii diagnoses. Behavior Therapy, 27, 67–77.
(2002). Body dysmorphic disorder in outpatients with major depression. Journal of Affective Disorders, 69, 141–148.
(2001). Prevalence of body dysmorphic disorder in a community sample of women. The American Journal of Psychiatry, 158, 2061–2063.
(2005). The broken mirror: Understanding and treating body dysmorphic disorder (rev. and exp. ed.). Oxford: Oxford University Press.
(2006). An open-label study of escitalopram in body dysmorphic disorder. International Clinical Psychopharmacology, 21, 177–179.
(2002). A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Archives of General Psychiatry, 59, 381–388.
(2005). Suicidal ideation and suicide attempts in body dysmorphic disorder. The Journal of Clinical Psychiatry, 66, 717–725.
(2006). Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Research, 141, 305–314.
(1998). Efficacy and safety of fluvoxamine in body dysmorphic disorder. The Journal of Clinical Psychiatry, 59, 165–171.
(2001). Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder. Psychosomatics, 42, 504–510.
(1993). Body dysmorphic disorder: 30 cases of imagined ugliness. The American Journal of Psychiatry, 150, 302–308.
(2009). A prospective pilot study of levetiracetam for body dysmorphic disorder. CNS Spectrums, 14, 252–260.
(2005). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics, 46, 317–325.
(2006). Delusional versus nondelusional body dysmorphic disorder: clinical features and course of illness. Journal of Psychiatric Research, 40, 95–104.
(2013). A 4-year prospective observational follow-up study of course and predictors of course in body dysmorphic disorder. Psychological Medicine, 43, 1109–1117.
(2003). An open-label study of citalopram in body dysmorphic disorder. The Journal of Clinical Psychiatry, 64, 715–720.
(2008). Functional impairment in body dysmorphic disorder: a prospective, follow-up study. Journal of Psychiatric Research, 42, 701–707.
(2003). A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Research, 122, 13–19.
(2012). Multiaxiales Klassifikationsschema für psychische Störungen des Kindes- und Jugendalters nach ICD-10 der WHO: Mit einem synoptischen Vergleich von ICD-10 mit DSM-IV (6. Aufl.). Bern: Huber.
(2006). The prevalence of body dysmorphic disorder: a population-based survey. Psychological Medicine, 36, 877–885.
(1996). Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behaviour Research and Therapy, 34, 717–729.
(2011). Modular cognitive-behavioral therapy for body dysmorphic disorder. Behavior Therapy, 42, 624–633.
(2006). A meta-analysis of psychological and pharmacological treatments for body dysmorphic disorder. Behaviour Research and Therapy, 44, 99–111.
