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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.
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 can sometimes seem similar to other conditions, such as an eating disorder or obsessive-compulsive disorder. 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). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
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 impairment in your social, work, school or other areas of functioning
- Moore DP, et al. Body dysmorphic disorder. In: Moore DP, et al. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa.: Mosby, Inc.; 2004. http://www.mdconsult.com/das/book/body/107599999-2/0/1243/0.html. Accessed Aug. 20, 2008.
- Castle DJ, et al. An update on body dysmorphic disorder. Current Opinion in Psychiatry. 2006;19:74-78.
- Buescher LS, et al. Body dysmorphic disorder. Dermatologic Clinics. 2006;24:251-257.
- Body dysmorphic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Arlington, Va.:American Psychiatric Association, 2000. www.psychiatryonline.com. Accessed Aug. 20, 2008.
- Hunt TJ, et al. The mirror lies: Body dysmorphic disorder. American Family Physician. 2008;78(2):217-222, 223-224.
- Phillips KA, et al. Body dysmorphic disorder: Treating an underrecognized disorder. American Journal of Psychiatry. 2008;165(9).
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 17, 2008.
