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A 19-year-old female spends 3-4 hours daily examining her nose in mirrors. She believes her nose is severely deformed, though others tell her it looks normal. She has consulted two plastic surgeons who found no abnormality. She avoids social events because of her perceived defect. She does not restrict food intake and her BMI is 22. What is the MOST likely diagnosis?
Explanation
BDD features preoccupation with perceived appearance defects not observable to others, repetitive checking behaviors, and functional impairment. It is classified in the OCD spectrum but is distinguished by the appearance-specific focus. The insight specifier (good, poor, absent/delusional) should be assessed.
Key Takeaway
BDD = preoccupation with perceived appearance defects that are not observable to others + repetitive checking behaviors + functional impairment. Differentiate from OCD (broader obsessions), social anxiety (fear of evaluation, not appearance-specific), and AN (weight/shape, not specific features).