What are the key diagnostic criteria for Body Dysmorphic Disorder (BDD) according to NICE guidelines?

Key diagnostic criteria for Body Dysmorphic Disorder (BDD) according to NICE guidelines include:

• Excessive preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
• Appearance concerns that cause significant distress or impairment in social, occupational, or other important areas of functioning.
• The preoccupation with appearance typically occupies more than 1 hour per day, which is considered excessive.
• Individuals often experience hidden distress and disability related to their symptoms, which may be difficult to discuss.
• BDD is frequently associated with comorbid conditions such as depression, social phobia, OCD, eating disorders, and substance misuse, which should be considered during assessment.
• Risk assessment for self-harm and suicide is essential, especially if depression is also present.
• People seeking cosmetic or dermatological procedures with mild disfigurements or blemishes should be routinely assessed for BDD.
• Assessment should include direct questions such as: worries about appearance, specific concerns, time spent thinking about appearance, and the impact on daily life and social functioning.

Healthcare professionals should involve mental health specialists with expertise in BDD for assessment and management, particularly before cosmetic or dermatological interventions.

These criteria and assessment recommendations are derived from NICE CG31 on obsessive-compulsive disorder and body dysmorphic disorder: treatment ¹.