scholarly journals Body Dysmorphic Disorder in Adolescents

2019 ◽  
Vol 9 (1) ◽  
pp. 44-57
Author(s):  
Himanshu Sharma ◽  
Bharti Sharma ◽  
Nisheet Patel
Keyword(s):  
Cosmetic Surgery ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Age Of Onset ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Exact Relation ◽  
Treatment Approaches ◽  
Compulsive Disorder

Background and Objectives:Body Dysmorphic Disorder (BDD) is characterized by an abnormal preoccupation with alleged misshapen body parts. There is often poor insight and effort is made to hide the imagined defects, and consultation may be sought seeking unnecessary cosmetic surgery or procedures. It is underdiagnosed and established treatment protocols are lacking. The disease has a chronic and undulating course and is seriously compromises quality of life. Despite the fact that the prime age of onset of BDD is during adolescence relatively little has been written about it during this phase of life. This review aims to comprehensively cover the present understanding of BDD, including clinical features, epidemiology, psychopathology, nomenclature, comorbidity and management.Methods:A literature search was undertaken using suitable key words on Google Scholar, MEDLINE & PsychoINFO up to June 2018 limited to articles in English.Results:he prevalence of BDD is variable in the general and psychiatric population with equal gender distribution. Both sexes are equally affected. It is associated with poor functioning and a chronic course. There is considerable comorbidity and diagnostic overlap between BDD and obsessive-compulsive disorder, major depressive disorder, social anxiety disorder, anorexia nervosa, schizophrenia spectrum disorders and personality disorders. Psychiatric consultation is often late. Selective Serotonin Reuptake Inhibitors (SSRIs) and Cognitive Behavior Therapy (CBT) are currently the first line modalities for treatment. Internet based CBT, Acceptance and commitment therapy, and repetitive Transcranial Magnetic Stimulation (rTMS) are emerging treatment options.Conclusions:BDD is a complex disorder with still lot of uncertainty about its diagnostic placement, treatment approaches, especially for refractory patients, and prognosis. Further study is needed to clarify its prevalence, especially in adolescents; to fully understand its neurobiological aspects, to determine its exact relation to obsessive compulsive related disorders, and to develop better treatment approaches.

scholarly journals Schizophrenia with Co-morbid Obsessive-Compulsive Disorder: A Case Series

2021 ◽  
pp. 69-74
Author(s):  
Prakash B. Behere ◽  
Pooja Raikar ◽  
Debolina Chowdhury ◽  
Aniruddh P. Behere ◽  
Richa Yadav
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Case Series ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder

The frequency of co-morbidities like Obsessive Compulsive Disorder (OCD) is common in schizophrenia. Some studies have reported earlier age of onset, more positive and negative symptoms, more depressive symptoms, and worse prognosis in such patients. The phenomenology and management of OCD in schizophrenia is understudied. Evidence claims that the course of illness of both schizophrenia and bipolar disorders may be affected by obsessive-compulsive disorder whereas in other cases antipsychotic induced obsessive-compulsive symptoms have been observed. A meta-analysis of of schizophrenia and its co-morbid psychiatric conditions, found a prevalence of 12.1% for obsessive compulsive disorder, 9.8% for panic disorders, 12.4% for post-traumatic stress disorder and 14.9% for social phobia. SGAs like amisulpride and aripiprazole are found to be useful in the treatment of comorbid OCD in schizophrenia due to their negligible serotonergic properties. A combination of selective serotonin reuptake inhibitors (SSRI) with antipsychotics has been recommended by the American Psychiatric Association (APA) for treatment of comorbid OCD in schizophrenia. Escitalopram at a dose of 20 mg/day has been found to be beneficial in such cases while psychosis worsened with the use of fluvoxamine and clomipramine. Below is a series of seven cases of schizophrenia with co-morbid obsessive-compulsive symptoms who are on treatment for their illness from the psychiatric outpatient department of a rural hospital in central India.

scholarly journals CASE STUDY OF PERSON WITH BODY DYSMORPHIC DISORDER

2016 ◽  
Vol 4 (7) ◽  
pp. 102-108
Author(s):  
M. Senthil
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Supportive Therapy ◽  
Family Intervention ◽  
Somatoform Disorder ◽  
Pharmacologic Treatment ◽  
Body Parts ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This article presents a case study of client with Body dysmorphic disorder. Body dysmorphic disorder is an increasingly recognized somatoform disorder, clinically distinct from obsessive-compulsive disorder, eating disorders, and depression. Patients with body dysmorphic disorder are preoccupied with an imagined deficit in the appearance of one or more body parts, causing clinically significant stress, impairment, and dysfunction. The preoccupation is not explained by any other psychiatric disorder. Patients present to family physicians for primary care reasons and aesthetic or cosmetic procedures. Cosmetic correction of perceived physical deficits is rarely an effective treatment. Pharmacologic treatment with selective serotonin reuptake inhibitors and non-pharmacologic treatment with cognitive behavior therapy are effective. Body dysmorphic disorder is not uncommon, but is often misdiagnosed. Recognition and treatment are important because this disorder can lead to disability, depression, and suicide. Psychiatric social work assessment and intervention was provided to the person with Body dysmorphic disorder, focusing on to building for change in misbelieve and strengthening commitment to change. The psycho social intervention was provided to the patients and his family members. Sessions on Admission counseling, Family intervention, Supportive therapy, Psycho education, role play, reminiscence, Pre discharge counseling, Discharge Counseling and Social Group Work was conducted. At the end of the therapy, the client knowledge about the illness and coping skills has improved.

Pharmacological, experimental therapeutic, and transcranial magnetic stimulation treatments for compulsivity and impulsivity

CNS Spectrums ◽  
2013 ◽  
Vol 19 (1) ◽  
pp. 50-61 ◽  
Author(s):  
Stefano Pallanti ◽  
Eric Hollander
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Behavioral Therapy ◽  
Hair Pulling ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Hair Pulling Disorder

Obsessive-compulsive disorder (OCD) has been recently drawn apart from anxiety disorder by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and clustered together with related disorders (eg, hoarding, hair pulling disorder, skin picking), which with it seems to share clinical and neurophysiological similarities. Recent literature has mainly explored brain circuitries (eg, orbitofrontal cortex, striatum), molecular pathways, and genes (eg, Hoxb8, Slitrk5, Sapap3) that represent the new target of the treatments; they also lead the development of new probes and compounds. In the therapeutic field, monotherapy with cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs) is recommendable, but combination or augmentation with a dopaminergic or glutamatergic agent is often adopted. A promising therapy for OCD is represented by repetitive transcranial magnetic stimulation (rTMS), which is suitable to treat compulsivity and impulsivity depending on the protocol of stimulation and the brain circuitries targeted.

Treatment of obsessive-compulsive spectrum disorders with SSRIs

1998 ◽  
Vol 173 (S35) ◽  
pp. 7-12 ◽  
Author(s):  
E. Hollander
Keyword(s):  
Serotonin Receptor ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Serotonergic Activity ◽  
Pharmacological Challenge ◽  
Spectrum Disorders ◽  
Serotonin Receptor Agonists ◽  
The Relationship

Background Obsessive-compulsive spectrum disorders (OCSDs) are now recognised as distinct diagnostic entities related to obsessive-compulsive disorder (OCD). The features of OCSDs and OCD overlap in many respects including demographics, repetitive intrusive thoughts or behaviours, comorbidity, aetiology and preferential response to anti-obsessional drugs such as the selective serotonin reuptake inhibitors (SSRIs).Method Literature was reviewed and preliminary data from various studies were re-examined to assess the relationship between compulsivity and impulsivity, and between OCD and OCSDs.Results OCSDs include both compulsive and impulsive disorders and these can be viewed as lying at opposite ends of the dimension of risk avoidance. Compulsiveness is associated with increased frontal lobe activity and increased serotonergic activity, while impulsiveness is associated with reduced activity of these variables. Neural circuits affected by serotonergic pathways have been identified and pharmacological challenge of OCSD patients with serotonin receptor agonists have supported the involvement of serotonergic processes.Conclusions SSRIs such as fluvoxamine have established efficacy in OCD and preliminary studies indicate that they are also effective in OCSDs. The features of three specimen OCSDs –body dysmorphic disorder, pathological gambling and autism – and their treatment with SSRIs are reviewed.

scholarly journals High-Dose Glycine Treatment of Refractory Obsessive-Compulsive Disorder and Body Dysmorphic Disorder in a 5-Year Period

2009 ◽  
Vol 2009 ◽  
pp. 1-25 ◽  
Author(s):  
W. Louis Cleveland ◽  
Robert L. DeLaPaz ◽  
Rashid A. Fawwaz ◽  
Roger S. Challop
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Social Life ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Signs And Symptoms ◽  
High Dose ◽  
Severe Exacerbation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
H Pylori

This paper describes an individual who was diagnosed with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) at age 17 when education was discontinued. By age 19, he was housebound without social contacts except for parents. Adequate trials of three selective serotonin reuptake inhibitors, two with atypical neuroleptics, were ineffective. Major exacerbations following ear infections involving Group A -hemolytic streptococcus at ages 19 and 20 led to intravenous immune globulin therapy, which was also ineffective. At age 22, another severe exacerbation followed antibiotic treatment forH. pylori.This led to a hypothesis that postulates deficient signal transduction by the N-methyl-D-aspartate receptor (NMDAR). Treatment with glycine, an NMDAR coagonist, over 5 years led to robust reduction of OCD/BDD signs and symptoms except for partial relapses during treatment cessation. Education and social life were resumed and evidence suggests improved cognition. Our findings motivate further study of glycine treatment of OCD and BDD.

Obsessive-compulsive disorder in children and adolescents

1998 ◽  
Vol 173 (S35) ◽  
pp. 91-96 ◽  
Author(s):  
Mark Riddle
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Of Onset ◽  
Current Knowledge ◽  
Management Training ◽  
Behavioural Therapy ◽  
Epidemiologic Studies ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Essential Components

BackgroundObsessive-compulsive disorder (OCD) is a common psychiatric condition that usually emerges during childhood or adolescence. Over 80% of individuals with OCD have their onset before age 18 years. Epidemiologic studies suggest a prevalence of 1-2for adolescents.MethodThis article reviews current knowledge of paediatric OCD in the following areas: age of onset, nosology and classification, subtypes, prevalence, aetiology, pathophysiology, assessment, prognosis and treatment.ResultsEssential components of treatment include long-term commitment, care management and illness education. Specific components of treatment include cognitive-behavioural therapy, parent behaviour management training and medication.ConclusionsThe most effective treatments are selective serotonin reuptake inhibitors (e.g. fluvoxamine, sertraline) and exposure/response prevention.

Anxiety and the Spectrum of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 4-5 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Of Onset ◽  
The Other ◽  
Specific Response ◽  
Obsessive Compulsive ◽  
Important Place ◽  
Compulsive Disorder

This supplement to CNS Spectrums focuses on the obsessive-compulsive spectrum of disorders and their relationship to anxiety. Hollander and others pioneered the concept of the obsessive-compulsive spectrum in the early 1990s, and have described its breadth and overlap with other psychiatric disorders. While its place in the psychiatric nomenclature is uncertain, the obsessive-compulsive spectrum is intertwined with the anxiety disorders in both its symptoms and biologic substrates.Obsessive-compulsive disorder (OCD) has an important place at the center of the spectrum. While currently classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as an anxiety disorder, OCD is distinct from these conditions in the International Classification of Diseases. There is a strong rationale for its separation from the anxiety disorders. First, OCD often begins in childhood, whereas other anxiety disorders typically have a later age of onset. OCD has a nearly equal gender distribution, unlike the other anxiety disorders, which are more common in women. Studies of psychiatric comorbidity show that, unlike the other anxiety disorders, persons with OCD generally tend not to have elevated rates of substance misuse. Family studies suggest that first-degree relatives of persons with OCD have an elevated prevalence of OCD-related disorders including body dysmorphic disorder, hypochondriasis, and grooming disorders, but not other anxiety disorders except for generalized anxiety disorder. The brain circuitry that mediates OCD appears to be different from that involved in other anxiety disorders. Lastly, OCD is unique with regard to its specific response to selective serotonin reuptake inhibitors, while noradrenergic medications, effective in the anxiety and mood disorders, are largely ineffective. On the other hand, the benzodiazepines, which have little effect on OCD, are often effective for the other anxiety disorders.

scholarly journals The relationship between body dysmorphic disorder and obsessive-compulsive disorder: A systematic review of direct comparative studies

2018 ◽  
Vol 52 (11) ◽  
pp. 1030-1049 ◽  
Author(s):  
Amy Malcolm ◽  
Izelle Labuschagne ◽  
David Castle ◽  
Gill Terrett ◽  
Peter G Rendell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obsessive Compulsive Disorder ◽  
Visual Processing ◽  
Body Dysmorphic Disorder ◽  
Age Of Onset ◽  
Empirical Studies ◽  
Negative Evaluation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Pubmed Database

Objective: Current nosology conceptualises body dysmorphic disorder as being related to obsessive-compulsive disorder, but the direct evidence to support this conceptualisation is mixed. In this systematic review, we aimed to provide an integrated overview of research that has directly compared body dysmorphic disorder and obsessive-compulsive disorder. Method: The PubMed database was searched for empirical studies which had directly compared body dysmorphic disorder and obsessive-compulsive disorder groups across any subject matter. Of 379 records, 31 met inclusion criteria and were reviewed. Results: Evidence of similarities between body dysmorphic disorder and obsessive-compulsive disorder was identified for broad illness features, including age of onset, illness course, symptom severity and level of functional impairment, as well as high perfectionism and high fear of negative evaluation. However, insight was clearly worse in body dysmorphic disorder than obsessive-compulsive disorder, and preliminary data also suggested unique visual processing features, impaired facial affect recognition, increased social anxiety severity and overall greater social-affective dysregulation in body dysmorphic disorder relative to obsessive-compulsive disorder. Conclusion: Limitations included a restricted number of studies overall, an absence of studies comparing biological parameters (e.g. neuroimaging), and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. Risks of interpreting common features as indications of shared underlying mechanisms are explored, and evidence of differences between the disorders are placed in the context of broader research findings. Overall, this review suggests that the current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Age of Onset for Obsessive-Compulsive Disorder

1990 ◽  
Author(s):  
W. E. Minichiello ◽  
L. Baer ◽  
M. A. Jenike ◽  
A. Holland
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Age Of Onset ◽  
Obsessive Compulsive ◽  
Compulsive Disorder
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