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When imagination turns ugly.

For more than a century, mental health workers around the world have noted that some people experience feelings of unbearable ugliness due 10 an imagined physical defect. They may complain constantly of thinning hair, a monstrous nose, "devious-looking" eyebrows, or an odd-shaped face.

The first systematic study of this condition, officially dubbed "body dysmorphic disorder," uncovers considerable distress and anxiety among sufferers, who often avoid work or social activities because of embarrassment over their appearance. A link may exist between imagined ugliness and obsessive-compulsive disorder or mood disorders, such as severe depression, assert psychiatrist Katherine A. Phillips of McLean Hospital in Belmont, Mass., and her colleagues.

The researchers interviewed 17 men and 13 women treated for body dysmorphic disorder either at McLean Hospital or by private psychiatrists.

Participants cited an average of four, and as many as 13 different bodily preoccupations during their lives, compared with one or two mentioned in most published case reports. Symptoms usually appeared first around age 15, Phillips' team reports in the February AMERICAN JOURNAL OF PSYCHIATRY.

A large majority of volunteers checked their appearance in mirrors and other reflecting surfaces for at least four hours daily and attempted to hide their imagined defects when in public. Twelve had thought about or attempted suicide because of distress over their appearance. Only two acknowledged that their concerns involved imaginary defects.

Symptoms of imagined ugliness often eased for those taking either of two antidepressant drugs that boost the amount of the chemical messenger serotonin available to brain cells: clomipramine, which often diminishes the urges and rituals of obsessive-compulsive disorder, and fluoxetine (Prozac). All participants suffered from at least one other psychiatric disorder, most commonly severe depression, manic depression, obsessive-compulsive disorder, or social phobia (an intense fear of public scrutiny).

Before receiving psychiatric help, 22 volunteers sought plastic surgery, dental work, or special skin treatments. Bodily preoccupations generally increased among the eight who actually underwent these treatments.
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Title Annotation:body dysmorphic disorder linked to obsessive-compulsive and mood disorders
Publication:Science News
Article Type:Brief Article
Date:Feb 13, 1993
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