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Tests and diagnosis
By Mayo Clinic staffIf your doctor or mental health provider believes you may have body dysmorphic disorder or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms, and also check for any related complications. However, if you don't mention your concerns, it's possible that body dysmorphic disorder can go undiagnosed for a long time.
These exams and tests generally include:
- Physical exam. This may include measuring height and weight, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.
- Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
- Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide, self-harm or harming others.
Pinpointing which condition you have
It can be difficult to diagnose body dysmorphic disorder. This may be because you're so embarrassed about your appearance that you avoid medical help, because you don't reveal your true feelings to doctors or because you don't even realize that your body image is distorted. Also, body dysmorphic disorder has signs and symptoms that are similar to other conditions, such as an eating disorder or obsessive-compulsive disorder, so your doctor must rule these conditions out first. It can take some time and effort to get an accurate diagnosis. Be sure to stick with it, though, so that you can get appropriate treatment.
Diagnostic criteria for body dysmorphic disorder
To be diagnosed with body dysmorphic disorder, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association.
Symptom criteria required for a diagnosis of body dysmorphic disorder include:
- Being extremely preoccupied with an imagined defect or a minor flaw in your appearance
- Being so preoccupied with appearance that it causes you significant distress or problems in your social, work, school or other areas of functioning
- Body dysmorphic disorder. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec15/ch204/ch204b.html#sec15-ch204-ch204b-767. Accessed Sept. 1, 2010.
- Ford CV. Somatoform disorders. In: Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry, 2nd ed. New York, N.Y.: McGraw Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3287234. Accessed Sept. 1, 2010.
- Body dysmorphic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association: 2000. http://www.psychiatryonline.com. Accessed Sept. 1, 2010.
- Fiora P, et al. Body dysmorphic disorder: A complex and polymorphic affection. Neuropsychiatric Disease and Treatment. 2009;5:477.
- Hunt TJ, et al. The mirror lies: Body dysmorphic disorder. American Family Physician. 2008;78:217.
- Conrado LA, et al. Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features. Journal of the American Academy of Dermatology. 2010;63:235.
- Phillips KA, et al. Body dysmorphic disorder: Treating an underrecognized disorder. American Journal of Psychiatry. 2008;9:165.
- Ipser JC, et al. Pharmacotherapy and psychotherapy for body dysmorphic disorder (Review). Cochrane Database of Systematic Reviews. 2009;(1): CD005332.
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