Body dysmorphic disorder and violence

The growing literature on body dysmorphic disorder (BDD) contains little discussion of anger, aggression and violence in BDD although recent reports suggest they may be more common than previously suspected. A patient is described whose BDD manifested as an extreme preoccupation with acne and whose outbursts of rage and violent assaults resulted in detention in a medium secure unit. His BDD resolved on high doses of a selective serotonin reuptake inhibitor (SSRI) but the course of improvement in his disproportionate anger was less straightforward.