DYSMORPHOPHOBIA (grech, dys-+ morphe a form + phobos fear) — conviction available any imagined disfiguration or excessive reestimation available; most often it belongs to visible parts of a body, especially a face (e.g., to a form or the sizes of a nose, ears, lips), is more rare to extremities, generative organs. Similar conviction can concern or some one part of a body — monodysmorphophobia, or at the same time several — polydysmorphophobia. Refer also painful conviction in distribution of off-flavors to dismorfofobichesky frustration (a smell from a mouth, sweat, sperm, especially often intestinal gases etc.).
A clinical picture
Patients, as a rule, characterize the defect by means of the definitions expressing feeling of disgust: «an ugly nose», «ugly teeth», «awful hands» etc. Usually they aim to hide the painful experiences, to mask «defect» and to correct it in any way. In all ways available to them they cover «the ugly place»: invent special styles of clothes and headdresses, apply various bandages, avoid the crowded and lit places etc. Typically constant aspiration to correction of estimated defect, no arrangements and a razubezhdeniya at the same time help. In addition to the importunate address to doctors of the most various specialties (to surgeons — with a request to perform cosmetic operation, to endocrinologists — to increase «ugly small growth», to stomatologists — to pull out all «ugly teeth», etc.), patients with D. resort also to methods of self-correction, and not a safe way: cut this or that part of a body, without any appointment accept high doses of hormonal drugs, develop own system physical. exercises or absolutely special diet. A frequent type of such correction is persistent starvation, quite often observable at patients nervous anorexia (see). In the majority of observations dismorfofobichesky frustration represent a characteristic symptom complex — a triad: patol, conviction available of any defect (or a number of defects) in own appearance, as a rule, is followed by the ideas of the relation and a depression. At patol, convictions in distribution of off-flavors, in addition to this triad, can exist local senesthopathias (see), napr, in the field of an anus. patol, idea physical. a shortcoming irrespective of its contents in most cases is nonsense of paranoiac type, more rare the supervaluable education arising concerning and is even more rare than the insignificant, but sharply revaluated shortcoming which is really available — the idea of persuasive character. The ideas of the relation are expressed in resistant conviction that all people around, at once noticing physical. defect, laugh, exchange glances, take out handkerchiefs etc. The depression can be expressed in various degree: from an easy oligothymia to the heavy depression which is quite often accompanied with suicide tendencies and attempts. The combination of dismorfofobichesky frustration to psychopathic forms of behavior is quite typical (see. Psychopathies ).
The etiology and a pathogeny
D. most often meets at schizophrenia (cm.), especially at the erased its forms, and borderline cases (see. Psychopathies ). The leading role in D.'s formation at these diseases belongs to an age factor — it arises preferential in the pubertal and youthful period. D.'s emergence in clinic of borderline cases is promoted by various psychogenic influences anyway connected with idea of own appearance.
the Diagnosis is made on the basis of the overall characteristic picture of a disease, at Krom D. was created, these anamnesis and the status; at the same time it is necessary to establish what character D. — crazy has, supervaluable or persuasive. D.'s diagnosis can be helped in some cases by detection of a symptom of a mirror — regular examining of with a mirror. The differential diagnosis needs to be carried out with frustration of a body scheme (see. the Body scheme, frustration at mental diseases ).
Treatment and the forecast
Treatment and the forecast are defined by character of a basic disease. At D. cosmetic operations are categorically contraindicated (as well as holding any other «corrective» actions).
Prevention comes down to possible elimination in the pubertal and youthful periods of influence of various psychogenic factors which are especially connected with idea of own appearance.)
Bibliography: Korkina M. V. About some lines of the nosological specification of a syndrome of dysmorphophobia-dismorfomanii, in book: Nosological modification psikhopatol. syndromes, under the editorship of G. V. Morozov and M. G. Gulyamov, page 24, Dushanbe, 1974; Bourgeois M. L'autodysosmo-phobie et le syndrome ou delire olfactif de relation, Ann. med. - psychol., t. 2, p. 353, 1973; Liber man R. A propos des dysmorphophobies de G adolescent, Rev. Neuropsychiat. infant., t. 22, p. 695, 1974.
M of B. Korkina.