The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder

Jane is an attractive woman in her mid-thirties, tall, thin, and stately. She believes she is breathtakingly ugly. Tormented by what she sees as her huge nose, crooked lip, big jaw, fat buttocks, and tiny breasts, she has not left her house in six years. Though she lives in the same house as her mother, she once went two years without seeing her. When relatives come over, she avoids them, staying up on the third floor of the house, even on Thanksgiving. The one time she left the house--forced to see a doctor--she covered her face with bandages. Eventually, she attempted suicide. "I can't imagine any suffering greater than this. If I had a choice, I'd rather be blind or have my arms cut off. I'd be happy to have cancer." Jane has body dysmorphic disorder, or BDD. In The Broken Mirror, Dr. Katharine Phillips draws on years of clinical practice and detailed interviews with over 200 patients to bring readers the first book on this debilitating disease, in which sufferers are obsessed by perceived flaws in their appearance. Phillips describes severe cases, such as Jane's, but also a multitude of milder cases, such as Carl, a successful lawyer who uses his work to distract him from his supposedly thinning hair, yet says that he thinks about it constantly. Many sufferers are able to function very well in society, but remain secretly obsessed by their "hideous acne" or "horrible nose," sneaking constant peeks at a pocket mirror, or spend hours at a time redoing makeup. According to Phillips' research, BDD afflicts approximately 2% of the population, or nearly 5 million people. It is not an uncommon disorder, simply a hidden one, since sufferers are often embarrassed to tell even their closest friends about their concerns: one woman, after fifty years of marriage, still felt too uncomfortable to reveal her preoccupation to her husband. Besides the fascinating story of the disease itself, The Broken Mirror is also a literally lifesaving handbook for sufferers, their families, and their doctors. Left untreated, the torment of BDD can lead to psychiatric hospitalization and sometimes suicide. With treatment, many sufferers are able to lead normal lives. Phillips provides a quick self-assessment questionnaire, helping readers distinguish between normal concern with appearance and the obsession of BDD to determine whether they or someone they know have BDD. She includes warning signs for dermatologists and plastic surgeons, since they are the medical professionals who see BDD sufferers most often as they continually seek to "fix" their looks. Other chapters outline effective treatments for BDD using drugs and cognitive-behavioral therapy, answering often-asked questions about treatments. Finally, Phillips includes a chapter aimed at the friends and families of BDD sufferers. Profoundly affected by the disease themselves, since sufferers often refuse to attend weddings and other family events, or constantly ask loved ones for reassurance about their looks, those who care about someone with BDD will find both helpful advice and reassurance in this indispensable book. The Broken Mirror--the first book on this underrecognized disorder--is essential reading for the psychiatrists, mental health professionals, and other physicians who see these often undiagnosed patients; for the friends and family concerned and upset by a loved one who won't believe their reassurances; and for the millions who suffer from BDD in silence and secrecy.

Health, Fitness & Dieting

Katharine A. Phillips

Diseases & Physical Ailments

Oxford University Press

Discusses the growing numbers of men who are taking the quest for perfect muscles, skin, and hair too far, crossing the line from normal interest to pathological obsession

The Adonis Complex: The Secret Crisis of Male Body Obsession

Harrison G. Pope Jr.

Roberto Olivardia

Free Press

In Advancing DSM, leading psychiatric clinicians and researchers contribute case studies that are unresolved, are rife with controversy, and illuminate limitations of the current diagnostic system. Along with analysis of clinical cases, the contributors recommend broad changes to DSM to incorporate new knowledge from psychiatry and neuroscience and findings from new methods of diagnostic testing.
Advancing DSM is a rich treasury of intriguing information for all clinicians and researchers. You will Develop an understanding of some of the shortfalls of the current system that will help you make better clinical decisions. Accurate diagnosis is the foundation for selecting the best treatment, determining prognosis, and enhancing our understanding of patients. With the help of real-world case examples, you'll develop a solid understanding of the complexities involved in making clinical diagnoses. Learn about developments that will advance future editions of DSM. Find out how new developments in psychiatry and neuroscience and new diagnostic testing tools such as functional MRI are changing the face of psychiatric diagnosis and will inform future editions of DSM. Be alerted to some of the vital questions that must be answered before a new DSM is developed. Each chapter raises important questions to answer if we are to develop new, more accurate, and more reliable diagnoses. For example, how do we determine the causes of mental disorders? How do we define a mental disorder? How should the groupings of disorders be revised to reflect information on etiology and pathophysiology? What are the implications of laboratory testing and neuroimaging for psychiatric diagnosis and practice? and many more. 
DSM has been a landmark achievement for the field. By allowing reliable diagnosis, it has brought order out of chaos and fostered groundbreaking advances in research and clinical care. Advancing DSM will brief you on exciting changes in psychiatry today that will impact the DSM of tomorrow.

Advancing Dsm: Dilemmas in Psychiatric Diagnosis

Michael B. First

Harold Alan Pincus

Mental Health

Amer Psychiatric Pub Inc

Beset by contradictions, somatoform and factitious disorders have an unusually long, rich, and colorful historical and clinical tradition. Yet, some of them have received only limited empirical investigation.
This book continues that rich tradition by offering a broad and scholarly synthesis of the current knowledge -- and controversies -- about somatoform and factitious disorders. Here you'll find up-to-date, clinically focused overviews of these intriguing and often difficult-to-treat disorders.
Recognized experts present the latest findings along with insightful recommendations and illustrative case studies on Somatization disorder -- The evolution and problems of diagnostic criteria (e.g., its focus on symptom counting), epidemiology, clinical features, etiologic considerations, differential diagnosis (e.g., contrasted with depressive and anxiety disorders), evaluation (use of questionnaires), and treatment considerations (psychotherapy, psychotropic medications). Hypochondriasis -- History, clinical features, theoretical models (psychodynamic, cognitive-behavioral, and physiologic), research studies, and practical techniques for treatment (from pharmacotherapy to cognitive behavioral therapy to alternative treatments such as relaxation therapy). Body dysmorphic disorder -- History and prevalence, clinical features, treatment (including surgery and nonpsychiatric medical treatment), etiology and pathophysiology (its relationship to obsessive-compulsive, depressive, and eating disorders), and diagnosis and misdiagnosis. Conversion disorder -- Diagnostic criteria and clinical subtypes, history and definitions, models of symptom generation, functions served by conversion symptoms, associated features, epidemiology, demographic and disease course, comorbidity, differential diagnosis, and treatment (best done in collaboration with an internist, primary care physician, or neurologist). Factitious disorders (widely known as Munchausen syndrome, its most extreme subtype) -- Empirical evidence related to epidemiology and etiology; diagnosis, clinical description, prevalence, and associated costs; limitations of current approaches; the reliability and usefulness of differential diagnoses; comorbidity, etiology, and management.
Both concise and thorough, this extensively annotated volume clarifies the issues surrounding these fascinating disorders and offers practical guidance and recommendations, highlighting the pressing need for further research to improve patient care. As such, it will prove compelling reading for practicing psychiatrists and other physicians in any clinical setting who want to better understand the baffling complexities of these distressing disorders.

Somatoform and Factitious Disorders (Review of Psychiatry)

American Psychiatric Association Publishing

A must-have resource for both mental health professionals and laypeople, The Language of Mental Health: A Glossary of Psychiatric Terms transcends its title by offering not only a comprehensive, up-to-the-minute glossary of terms, both general and specialized, but also a full complement of features, including commonly used abbreviations, psychiatric measures, medications used in psychiatry, legal terms, and mental health resources. Each section is organized in a logical manner that optimizes ease of use and presentation. Although The Language of Mental Health is designed to be used primarily by professionals, patients and their families, mental health advocacy groups, attorneys, and others also will appreciate its many reader-friendly features. The definitions are written in a style that is direct and accessible, and the Web-savvy list of mental health resources is current and complete. Clinicians will value having critical information in a single volume concise, yet substantial enough to withstand frequent consultation and extended study. Utterly complete and yet accessible, The Language of Mental Health is the most current compendium of psychiatric terminology available today and is essential reading for practitioners, researchers, and residents.

The Language of Mental Health: A Glossary of Psychiatric Terms

Medical Books

Stuart C. Yudofsky

Robert E. Hales

Narriman C. Shahrokh

Medicine

American Psychiatric Publishing, Inc.

Obsessive-compulsive and related disorders (OCRDs) are both prevalent and a source of significant impairment for patients who suffer from them, yet they remain underrecognized and underdiagnosed. Handbook on Obsessive-Compulsive and Related Disorders provides comprehensive and cutting-edge coverage of OCRDs for clinicians and trainees in the context of the new classification framework established by the DSM-5. Chapters cover OCD, body dysmorphic disorder (BDD), hoarding disorder, trichotillomania (hair pulling disorder), excoriation (skin picking) disorder, and illness anxiety disorder, among other related conditions, ensuring that readers are current on both the research on and the standard of care for these illnesses. In addition, each chapter employs a logical and consistent structure, addressing diagnostic criteria and symptomatology, epidemiology, etiology and pathophysiology, comorbidities, course and prognosis, assessment and differential diagnosis, psychosocial impairment and suicidality, and other topics such as cultural and gender-related issues. Treatment approaches and considerations are explored in-depth. The Handbook's useful features are many: * The first book focused on the OCRDs to be published since the development of DSM-5, it reflects a deep understanding of the disorders and the DSM-5 development process. Readers can depend on the utmost compatibility with DSM-5 because the book was edited by the chair of the DSM-5 work group, and the chair of the sub-work group, that oversaw the development of the OCRD category. The editors have provided a helpful introductory chapter that thoroughly addresses the changes from DSM-IV.* The book includes a chapter on disorders that were seriously considered for, though ultimately not included in, the DSM-5 OCRD chapter and for which research offers some support for a close relationship to OCD. These include tic disorders, illness anxiety disorder (hypochondriasis), and obsessive-compulsive personality disorder.* Case studies are provided in each chapter, as well as key clinical points, both of which help the reader understand, contextualize, and make use of the book's content. Recommended readings at the end of each chapter offer the opportunity to deepen understanding. The costs to society of undiagnosed and/or untreated OCRD are high in both human and financial terms, and clinicians need to master all available tools to help patients and families understand and cope with these disorders. Handbook of Obsessive-Compulsive and Related Disorders deserves a prominent position -- both in the literature and on the clinician's bookshelf.

Handbook on Obsessive-Compulsive and Related Disorders

The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder (Chinese Edition)

Psychology & Counseling

World Publishing Corporation

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Books by Katharine A. Phillips