An article published in this week’s British Medical Journal reports that an increasing number of men suffer from body dysmorphic disorder (BDD) compared to 25 years ago, and that the condition is under-recognized and underdiagnosed.

“Men and boys are often reluctant to reveal their symptoms because of embarrassment and shame, and they typically do not recognize that their beliefs about their appearance are inaccurate and due to a psychiatric disorder,” say study authors Katherine Phillips, MD, director of the Body Dysmorphic Program at Brown University School of Medicine in Providence, RI and David Castle, professorial fellow at the Mental Health Research Institute and the University of Melbourne in Australia.

According to the report, even though concerns about appearance can seem trivial, many patients who suffer from BDD are admitted to a hospital, become housebound, and even attempt suicide. Sufferers also become socially isolated and experience problems at work.

The trend for men to look muscular has also caused body-image problems, according to the report. Signs to look for in suspected BDD patients include  examining, fixing, or hiding the perceived defect; checking how they look in the mirror; comparing themselves with others; excessive grooming; and seeking reassurance about how they look.

The authors note that more physicians need to be aware of BDD because patients often do not talk about their body image concerns and many patients are mistreated for their dermatological, surgical or nonpsychiatric treatment, which is ineffective.

“The challenge is to enhance both physicians’ and the public’s awareness of body dysmorphic disorder so that effective treatments can be offered and unnecessary suffering and morbidity avoided,” say the authors.

[news.bbc.co.uk, October 24, 2006]