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Dysmorphophobia – A Centenary Discussion

Published online by Cambridge University Press:  05 October 2018

S. A. Birtchnell
S. A. Birtchnell*
Affiliation:
Department of Psychiatry, St George's Hospital, Blackshaw Road, London SW17 10QT, UK
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Extract

The term ‘dysmorphophobia’ was first defined by Morselli (1886) who wrote of it as “a subjective feeling of ugliness or physical defect which the patient feels is noticeable to others, although his appearance is within normal limits”. A century later there is continuing debate as to its status as symptom, syndrome or discrete psychiatric illness. Misleadingly, it is not a phobia and there is no fear of physical abnormality per se – the ugliness of others is tolerated, although the patient may well be apprehensive regarding the response he anticipates his appearance will provoke in others. As a symptom the feeling may be expressed as a preoccupation with appearance, an obsession, overvalued idea or frank delusion. The accompanying self-consciousness may similarly range to full-blown delusions of reference. To some extent the failure of some authors, reporting on dysmorphophobic patients, to specify clearly the level at which the belief is held, has confounded clarification of the phenomenon.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 153 , Issue S2: The Psychopathology of Body Image , 1988 , pp. 41 - 43
Copyright
Copyright © 1988 The Royal College of Psychiatrists 

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