“I will not show my mouth”: a case report of a young female patient with body dysmorphic disorder

Body dysmorphic disorder (BDD) is clinically distinct from obsessive-compulsive disorder, eating disorders, and depression. In clinical settings, BDD usually goes unrecognised and undiagnosed. There is a preoccupation with either an ‘‘imagined’’ defect in one’s appearance or markedly excessive concern over a slight physical anomaly. The most common preoccupations are with the nose, skin, hair, eyes, eyelids, mouth, lips, jaw, and chin. We report a case of body dysmorphophobia in an adult female presenting with severe depression with suicidal ideation. She improved on selective serotonin reuptake inhibitor, and exposure and response prevention and cognitive behaviour therapy. Patients with BDD do not consult mental health professionals primarily. Rather, they seek treatment by general practitioners, dermatologists, dentists, and plastic surgeons. It is necessary that more clinicians are informed about the disorder.