This case note sludy examined the clinical features and outcome of 30 patients with dysmorphophohia (perhaps (he largest series so far) who had behavioural (exposure) therapy. Method: The clinical Features and treatment outcome on standard contemporary measures were reviewed. Results: All palienls had social avoidance and dysmorphophohia, with abnormal beliefs, often of delusional intensity. For up lo 1-12 months follow-up after exposure, most patients improved in avoidance, work and social adjustment, and in beliefs even if these had initially been delusional. Gains were less than after exposure therapy for non-dysmorphophobic problems such as agoraphobia, specific phobia, social phobia and obsessive-compulsive disorder (OCT)). Conclusions: The importance of separating delusional from delusional dysmorphophohia can be questioned. Exposure therapy appeared useful for dysmorphophohia, but this must be confirmed in a controlled trial and in patients who attend dermatology, plastic surgery and general psychiatric clinics.
