Body dysmorphic disorder: Classification challenges and variants

2017 ◽  
Vol 41 (S1) ◽  
pp. S459-S459
Author(s):  
N. De Uribe-Viloria ◽  
A. Alonso-Sanchez ◽  
S. Cepedello Perez ◽  
M. Gomez Garcia ◽  
M. De Lorenzo Calzon ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Body Dysmorphic Disorder ◽  
Treatment Options ◽  
Obsessive Compulsive ◽  
Dsm 5 ◽  
Bibliographic Search ◽  
Dsm Iv ◽  
Competing Interest ◽  
Core Symptoms

IntroductionThe main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight to others. Previously, its delusional and nondelusional variants were sorted in two separate categories, but owing to new data suggesting that there are more similitudes than differences between them, DSM-5 now classifies both as levels of insight of the same disorder.ObjectivesTo enunciate the similarities and differences between the two variants of BDD.AimsTo better understand the features and comorbidity of BDD, so as to improve its management and treatment.MethodsTaking DSM-5 and DSM-IV-TR as a reference, we have made a bibliographic search in MEDLINE (PubMed), reviewing articles no older than 5 years that fit into the following keywords: body dysmorphic disorder, delusions, comorbidity, DSM-IV, DSM-5.ResultsBoth the delusional and nondelusional form presented many similarities in different validators, which include family and personal history, pathophysiology, core symptoms, comorbidity, course and response to pharmacotherapy.ConclusionsThe new classification of delusional and nondelusional forms of BDD as levels of insight of the same disorder, which places them closer to the obsessive-compulsive spectrum than to the psychotic one, not only improves treatment options, but also reinforces the theory that delusions are not exclusive of psychotic disorders, setting a precedent for the understanding and classification of other disorders with delusional/nondelusional symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Classification of Body Dysmorphic Disorder and Relevance for Patient Care

2017 ◽  
Author(s):  
Katharine A. Phillips
Keyword(s):  
Patient Care ◽  
Body Dysmorphic Disorder ◽  
Somatoform Disorder ◽  
Repetitive Behaviors ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dsm Iv

The classification of body dysmorphic disorder (BDD) in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) has evolved over the decades. This chapter discusses these changes and highlights their relevance to patient care. BDD was first briefly mentioned in DSM-III (1980). DSM-III-R (1987) was the first edition of DSM to classify BDD as a separate disorder and provide diagnostic criteria. The most notable changes introduced in DSM-IV (1994) and DSM-5 (2013) were the addition of a clinical significance criterion to DSM-IV and the addition of a repetitive behaviors criterion, as well as specifiers for insight and muscle dysmorphia, in DSM-5. Earlier editions of DSM classified delusional BDD symptoms as a distinct psychotic disorder, whereas DSM-5 classifies such beliefs as BDD with the absent insight specifier and as the same disorder as nondelusional BDD. DSM-5 also moved BDD to a new chapter; it is now classified as an obsessive-compulsive and related disorder rather than a somatoform disorder. This change has important implications for how BDD is conceptualized.

I Don't Recycle! An Organic Hoarding Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S640-S641
Author(s):  
L. Garcia Ayala ◽  
M. Gomez Revuelta ◽  
C. Martin Requena ◽  
E. Saez de Adana Garcia de Acilu ◽  
O. Porta Olivares ◽  
...  
Keyword(s):  
Social Services ◽  
Home Visit ◽  
Treatment Options ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
The Social ◽  
Competing Interest ◽  
Rule Out

IntroductionHoarding often occurs without the presence of obsessive-compulsive disorder (OCD), showing distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Furthermore, it presents itself secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as independent diagnosis in DSM-5.ObjectivesWe aim to expose the possible organic etiology of a hoarding disorder case with atypical presentation.Materials and methodsWe present a case of a 48 years old male patient who was brought to the hospital by the police after being reported for unhealthy conditions in his home. In the home visit paid by the Social Services an excessive hoarding of objects and trash was detected. A possible hoarding disorder was diagnosed in the psychiatric assessment. Among other diagnostic test, a brain CT was conducted, in which a frontal meningioma was identified. After surgical treatment, hoarding symptoms diminished significantly.DiscussionA significant part of the hoarding disorders are attributed to primary psychiatric disorders, resulting in potentially treatable organic pathology going unnoticed.ConclusionIt's important to rule out organic etiology before proceeding to make a definitive hoarding disorder diagnosis, optimizing that way the treatment options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychotic disorders in DSM-5 and ICD-11

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 349-354 ◽  
Author(s):  
Falko Biedermann ◽  
W. Wolfgang Fleischhacker
Keyword(s):  
Psychotic Disorders ◽  
Work Group ◽  
Theoretical Background ◽  
Classification Systems ◽  
World Health ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Health Organization ◽  
Diagnostic Criterion

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.

scholarly journals Obsessive-Compulsive Spectrum Phenomena and the DSM-V Developmental Process

CNS Spectrums ◽  
2008 ◽  
Vol 13 (2) ◽  
pp. 107-108 ◽  
Author(s):  
Eric Hollander
Keyword(s):  
Psychotic Disorders ◽  
Developmental Process ◽  
International Classification Of Diseases ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm V ◽  
Classification Of Diseases ◽  
Psychotic Features

Several of this month's articles and interviews touch on themes that relate to spectrum phenomena as well as the Diagnostic and Statistical Manual of Mental Disorders developmental process.First, Darrel A. Regier, MD, MPH, director of the Division of Research at American Psychiatric Association, discusses, in an interview with CNS Spectrums, the developmental process for DSM-V. He emphasizes the use of dimensional measures to determine both thresholds for disorders, and to assess response to treatments. He also highlights a focus on spectra of disorders that cut across traditional diagnostic boundaries as one way to deal with issues of comorbidity. Finally, he discusses new approaches to the five DSM axes, and the need to link together the DSM and International Classification of Diseases processes. Three other articles in this issue also clearly relate to these obsessive-compulsive spectra issues.For example, Leonardo F. Fontenelle, MD, PhD, describes how, although much attention has been paid to patients who lack insight into their obsessional beliefs, less importance has been given to individuals with obsessive-compulsive disorder (OCD) who display perceptual disturbances typically found in psychotic disorders, including schizophrenia, schizoaffective disorders, or mood disorders with psychotic features. The authors call attention to a phenomenon that has been neglected in the psychiatric literature (ie, the occurrence of hallucinations and related phenomena in patients with OCD). They describe five patients with OCD with hallucinations in several different sensory modalities, including the auditory, the visual, the tactile, the olfactory, and the cenesthetic modalities, and suggest that further psychopathological research should clarify the clinical significance of hallucinations among patients with OCD.

Intravenous, Pulse-Loaded Clomipramine in Body Dysmorphic Disorder: Two Case Reports

CNS Spectrums ◽  
1996 ◽  
Vol 1 (2) ◽  
pp. 54-57 ◽  
Author(s):  
Stefano Pallanti ◽  
Lorrin M. Koran
Keyword(s):  
Body Dysmorphic Disorder ◽  
Case Reports ◽  
Controlled Trial ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Dsm Iv ◽  
Surgical Treatments ◽  
Delusional Disorder Somatic Type

AbstractBody dysmorphic disorder (BDD) is characterized by excessive preoccupation with an imagined or greatly exaggerated defect in appearance, and often by related rituals or pursuit of medical or surgical treatments. The frequent comorbidity of BDD with obsessive-compulsive disorder (OCD) and the phenomenological similarities between these two disorders suggest that they may be related. BDD reportedly responds to oral clomipramine (CMI).We present here two case studies of patients meeting DSM-IV criteria for BDD with comorbid delusional disorder, somatic type, to whom we administered pulse-loaded intravenous (IV) CMI (150 mg on day 1, 200 mg on day 2). After a 4.5-day drug holiday, both patients continued on oral CMI. As reflected in modified Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, both patients' BDD improved by about one third within 4.5 days of the second IV dose. Improvement continued over 2 months on oral CMI, and comorbid major depression present in one patient remitted. By the end of 8 weeks of oral CMI, the patients' modified Y-BOCS scores had decreased about 55%, and their social functioning had markedly improved.As in OCD, pulse-loaded, IV CMI may produce a much faster response than oral CMI or selective serotonin reuptake treatment and can be well tolerated. This treatment approach to BDD deserves further study in a prospective, randomized controlled trial.

Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Anna Marras ◽  
Naomi Fineberg ◽  
Stefano Pallanti
Keyword(s):  
International Classification Of Diseases ◽  
Classification Systems ◽  
World Health ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Draft Version ◽  
Health Organization

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders(DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO)International Classification of Diseases(ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.

Sign in / Sign up

Export Citation Format

Share Document