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BDD diagnosis has been updated!

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BDD diagnosis has been updated!

Postby Mattch » Mon Jul 01, 2013 6:10 am

Hi All,
Hey, the new Diagnostic and Statistical Manual of Mental Disorders, 5th ed.. [DSM–5] (American Psychiatric Association, 2013) has changed the diagnosis of BDD from a 'somatoform disorder' in to the diagnostic criteria of Obsessive-Compulsive and Related Disorders. It is a reflection of up-to-date research and clinical review that shows BDD is part of the OCD spectrum of disorders.

Because of its focus on the body, Body Dysmorphic Disorder has historically been classified as a somatoform disorder. However, in DSM-5, BDD has moved to the Obsessive Compulsive and Related Disorders chapter to reflect its similarities in presentation and treatment to OCD.

In addition to adjusting BDD’s structural placement within the manual, the DSM-5 includes a few changes with regard to the BDD diagnostic criterion. The criteria for BDD include, “preoccupation with one or more perceived defects or flaws in appearance that are not observable or appear slight to others.” This represents a change from the DSM-IV criteria which describe the individual’s “defects or flaws in appearance” as imagined, instead of perceived. Although these “flaws” may seem imagined to friends and family members of the person suffering from BDD, these imperfections may seem incredibly real to the individual. Thus, the wording has been changed to more accurately capture the experience of individuals with BDD. The DSM-5 diagnostic criteria additionally feature a newly added criteria that at some point during the disorder, the person has performed repetitive behaviors (mirror checking, grooming, etc.) or mental acts (comparing appearance to others) in response to their appearance concerns. This criterion is consistent with the symptomotology of BDD and reflects BDD’s position in the Obsessive Compulsive and Related Disorders chapter. Notably, the DSM-V criteria also include a specifier for muscle dysmorphia (the belief that one’s body is too small or insufficiently muscular), a subtype of BDD.

Other disorders in the Obsessive Compulsive and Related Disorders chapter include Excoriation Disorder (Previously, Skin Picking and a new addition to the DSM-5) and Hair Pulling Disorder (named changed from Trichotillomania). The DSM-5 is out now, and as such may/will (?) change the way the psych community see, treat and diagnose us!

On an extra note, I hope it is possible that the psych forums can move the BDD section of the forum to another section to fit into the latest psychiatric understanding of BDD? (And, I have asked a mod and also posted in the members section to request this change... so just be aware if the link to this forum changes? Not sure if it will!).

Kind regards,
Mattch.
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Re: BDD diagnosis has been updated!

Postby Beyond_words » Thu Jul 04, 2013 6:13 pm

Hi Mattch!

I applaud this decision to re-categorize BDD by the DSM; it makes much more sense. I never could understand what BDD was doing there amongst the somatoforms. I suppose it's not as if having it in the category of somatoform disorders was undermining of the legitimacy of BDD, and subsequently making life even harder for sufferers by in some way downplaying the importance of the severity of symptoms. But in a sense, it was even worse than that: it was almost as if it had been placed in some miscellaneous category, because nobody knew quite what to do with it, where it would be largely ignored and in time forgotten about.

As regards the second point about the rewording of the definition (or re-assessment of the diagnostic criteria, if you will), I suggest that it is only a slight semantic alteration (almost 'cosmetic', if you'll pardon the pun). I consider it will make little difference in the eyes of the therapist - whether "imagined", "perceived" or whatever, a good therapist is able to grasp the concept that what is very real to the sufferer, is not perceived by everyone else. But more importantly, although it is a step in the right direction, I fear it is not yet enough to somehow transmit to the general populace (i.e. those who aren't BDD-sufferers) that this is not, as some would have it (and this is best-case scenario) some kind of lack of self-esteem gone out of control; or (worse-case scenario) vanity!

So much is still misunderstood. But it cheers me to know that much work still seems to be being done to remedy some of these problems - and, of course, towards finding a cure for this wretched thing.

Peace out,
BW
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Re: BDD diagnosis has been updated!

Postby Mattch » Wed Jul 24, 2013 9:18 am

Ok, so I am pushing a point: And tying to nicely try to point out that "we/the forum" must have had some kind of system in place to put the mental disorders into the sections they are in on this forum. Therefore, BDD has -for the last decade (10 years)- been seen by the experts in the field and by published research to be an anxiety disorder and part of the OCD spectrum and NOT a SOMATOFORM disorder..... so please, now that it has officially been changed into the anxiety disorder/OCD Spectrum disorder category, can we move the BDD section? PLEASE!
Healthy regards ( for my BDD community and other's understanding,
Mattch
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Re: BDD diagnosis has been updated!

Postby Mattch » Thu Aug 08, 2013 6:33 am

Thanks to the Mods for considering the forum category change (to fit current understanding of BDD),

I must say that I dislike clicking into the Somatoform forum as I feel that it (me &) people with BDD feel like their concerns and anxiety are 'not real'/ 'made up'.

It is really a massive change to the up-to-date diagnosis of BDD.... please do not underestimate the ripple effects it has on people with BDD. As said, the reason for changing the BDD section are outlined in my above posts. Please consider the request.

Healthy regards,
Mattch
Mattch
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