Body Dysmorphic Disorder and the DSM-IV: The Demise of Dysmorphophobia

To some extent, the failure of some authors, reporting on dysmorphophic patients, to specify clearly the level at which the belief is held, has confounded clarification of the phenomenon. Birtchnell (1) Dysmorphophobia is a controversial term. It is not a phobia, reliable data on it are few, and many authors write about it without attempting to define it. DSM-III-R introduced the term “body dysmorphic disorder” to describe a non-psychotic condition in which there is pathological preoccupation with physical appearance and with the intention of replacing the term “dysmorphophobia”. However, psychiatrists continue to use the word dysmorphophobia, often unaware that it may have several distinct meanings. This article, 1. demonstrates the current confusion in terminology, 2. elaborates on DSM-III-R's concept of body dysmorphic disorder, and 3. suggests refinements for the DSM-IV description.