In 1891, an Italian doctor, Morselli, first coined the term dysmorphophobia, from ‘dysmorph’ a Greek word meaning mis-shapen. He described it as a subjective feeling of ugliness despite a normal appearance. Freud once described a patient whom he called the “Wolf man” who had classical symptoms of BDD. The patient believed that his nose was so ugly that he avoided all public life and work. The media sometimes refer to BDD as “Imagined Ugliness Syndrome”. For the person with BDD though, the ugliness is very real. BDD was not published in the Diagnostic and Statistical Manual of Mental Disorders until 1987. It was subsequently renamed Body Dysmorphic Disorder in 1997 in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) under the somatoform disorders.

The degree to which people experience BDD varies so that some people will acknowledge that they may be blowing things out of all proportion. Others are so firmly convinced about their defect that they are regarded as having a delusion. Whatever the degree of insight into their condition, people with BDD often realise that others think their appearance to be ‘normal’ and have been told so many times. They usually distort these comments to fit in with their views (for example, “They only say I’m normal to be nice to me” or “They say it to stop me being upset”). Alternatively, they may firmly remember one critical comment about their appearance and dismiss 100 other comments that are neutral or complimentary.

* previously known as dysmorphophobia and sometimes referred to as body dysmorphia or dysmorphic syndrome