Body Dysmorphic Disorder

Obsessive-compulsive disorders (OCDs) is a term that refers to anxiety disorders that are characterized by uncontrollable obsessions and compulsions. The condition is a chronic, long-lasting disorder in which the individual has recurring thoughts and behaviors. The obsessive and compulsive symptoms can affect all aspects of a person’s life including personal relationships, school and work. There are various kinds of obsessive-compulsive disorders with different signs and symptoms as well as treatment approaches. This paper discusses treatment recommendations for an adult patient suffering from Body Dysmorphic Disorder. The discussion includes analysis of medical management, community resources and follow-up plans for the patient’s condition.
HPI and Clinical Impression for the Client
Jane is a 38-year old individual diagnosed with Body Dysmorphic Disorder, which is an obsessive-compulsive disorder characterized by recurring thoughts regarding perceived flaws or defects in appearance (Mayo Clinic Staff, 2016). Jane developed this condition following a history of body shaming by her schoolmates and colleagues at work. Since her high school years, Jane has always viewed herself as ugly and subsequently developed this obsessive-compulsive disorder. She is obsessed with the appearance of her face, hair and skin, which she considers to have defects and flaws and contributed to her body shaming. She not only compares herself to others on a constant basis, but has also performed repetitive behaviors or acts of grooming to improve her appearance. Some of Jane’s symptoms include behaviors that are focused on fixing the perceived defects/flaws, comparison with others, perfectionist tendencies, preoccupation with perceived defects, and attempts to hide the perceived defect.
Psychopharmacologic Treatments
The treatment of obsessive-compulsive disorders like Body Dysmorphic Disorder involves the use of different treatment approaches including pharmacologic interventions, cognitive-behavioral therapy, and other psychosocial interventions (Ahmed et al., 2019). Psychopharmacologic treatments for this condition entail a combination of medication and psychotherapy approaches. For Jane, the recommended medication is selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, citalopram, escitalopram and fluvoxamine. These psychopharmacologic treatments are suitable for the patient since they are the recommended drug treatment by the U.S. Food and Drug Administration.
Psychotherapy
The recommended psychotherapy approach is Cognitive Behavior Therapy since it would help generate consistent improvement in severity of her symptoms and quality of life. As a behavioral modification therapy, this approach would improve Jane’s condition through cognitive restructuring, perceptual retraining, and relapse prevention. The recommended psychotherapy for this patient should be provided through individual, family and group approaches. Individual psychotherapy would focus on assisting the patient to understand the causes of this disorder, its severity, and how to deal with it. Family and group psychotherapy would act as a support system that promotes behavior modification in the patient.
Medical Management Needs
The patient’s primary care needs include medication management and suitable treatment therapeutic regimen. In this regard, the patient needs to take the appropriate dosage of antidepressant medications or SSRIs. Maintaining appropriate dosage is critical since some of these medications have adverse side effects. Appropriate therapeutic regimen is essential to promote behavioral modification in the patient and result in better outcomes. Primary care physicians should work in collaboration with other healthcare professionals and specialists to provide appropriate treatment for the patient (Phillips, 2006).
Community Support Resources and Community Agencies
Treatment of obsessive-compulsive disorders like Body Dysmorphic Disorder also entails the involvement of community agencies and resources. For Jane, the treatment process would involve participating in community mental health teams (CMHTs), which have been increasing and widening in recent years (Harris & Drummond, 2016). Community mental health teams provide community psychiatric services, which would be helpful for Jane to deal with her condition. Some of the community agencies that would provide necessary support to Jane include the Body Dysmorphic Disorder Foundation and Anxiety and Depression Association of America.
Plan for Follow-up
Continuation and maintenance of treatment for this patient requires a comprehensive follow-up involving collaboration of healthcare professionals as part of a treatment alliance (Phillips & Hollander, 2008). Primary care physicians should collaborate with other clinicians to conduct monthly assessment of the patient and make necessary changes to the treatment regimen depending on the patient’s progress and outcomes in the treatment process. Changes in the treatment process following monthly assessments help improve patient outcomes.
In conclusion, Body Dysmorphic Disorder is an example of a compulsive-obsessive disorder that is characterized by recurring and uncontrollable obsessions and compulsions. Jane is a 38-year old patient suffering from this condition due to her history of body shaming since high school. The patient has shown obsession with perceived defects/flaws in her skin, face, and hair. The treatment plan for this patient requires a combination of psychopharmacologic treatments and psychotherapy and collaboration between different clinicians.
References
Ahmed et al. (2019, October 3). Body Dysmorphic Disorder Treatment & Management. Retrieved October 10, 2019, from https://emedicine.medscape.com/article/291182-treatment#d12
Harris, P.M. & Drummond, L.M. (2016, October). Compliance of Community Teams with Specialist Service Recommendations for Obsessive-Compulsive and Body Dysmorphic Disorders. BJPsych Bulletin, 40(5), 245-248.
Mayo Clinic Staff. (2016, April 28). Body Dysmorphic Disorder. Retrieved October 10, 2019, from https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/diagnosis-treatment/drc-20353944
Phillips, K.A. & Hollander, E. (2008, March). Treating Body Dysmorphic Disorder with Medication: Evidence, Misconceptions, and a Suggested Approach. Body Image, 5(1), 13-27.
Phillips, K.A. (2006, July). The Presentation of Body Dysmorphic Disorder in Medical Settings. Primary Psychiatry, 13(7), 51-59.