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Körperdysmorphe Störung

Epidemiologie, klinische Symptomatik, Klassifikation und differenzielle Therapieindikation—eine Übersicht

Body dysmorphic disorder

Epidemiology, clinical symptoms, classification and differential treatment indications: an overview

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Zusammenfassung

Die körperdysmorphe Störung („body dysmorphic disorder“; BDD) oder Dysmorphophobie ist eine relativ häufige Störung, klinisch gekennzeichnet durch eine übermäßige Beschäftigung mit einem eingebildeten Mangel oder einer befürchteten Entstellung der äußeren Erscheinung. Die übermäßige Beschäftigung verursacht einen oft hohen Leidensdruck und Beeinträchtigungen in sozialen, beruflichen oder anderen wichtigen Funktionen. Überwertige Ideen und Beobachtungswahn stellen weitere typische Symptome dar. Die BDD hat eine lange historische Tradition in der europäischen Psychiatrie. In die internationalen Klassifikationssysteme wurde sie 1987 mit dem DSM-III-R aufgenommen. Die BDD wurde nosologisch sowohl den Zwangsstörungen als auch den hypochondrischen Störungen zugeordnet. Aufgrund der verzerrten Körperwahrnehmung ergeben sich Verbindungen zur Zoenästhesie im Rahmen einer schizophrenen Psychose, den Essstörungen und der Transsexualität. In den letzten 10 Jahren wurden vermehrt wissenschaftliche Untersuchungen zur BDD durchgeführt. In dieser Übersichtsarbeit wird der gegenwärtige Kenntnisstand zur BDD anhand der relevanten wissenschaftlichen Literatur zusammengefasst. Die Therapieindikationen werden kritisch hinterfragt.

Summary

Body dysmorphic disorder (BDD), also known as dysmorphophobia, is a relatively common disorder that consists of preoccupation with some imagined or slight defect in physical appearance. The preoccupation causes emotional distress and social impairment. Overvalued ideation and referential thinking are prevalent. BDD has a rich tradition in European psychiatry, but it first entered the official psychiatric nomenclature as a separate disorder in DSM-III-R in 1987. In the last 10 years it has received increasing empirical attention. BDD has been hypothesized to be related to obsessive-compulsive disorder (OCD) or may be conceptualized as hypochondriacal disorder. According to its body image disturbance it has been related to cenesthesia, eating disorders, and transsexualism. This paper presents the current level of awareness about BDD based on an analysis of the relevant literature. Empirical data are summarized and clinical signs are described. Varying therapies are critically reviewed.

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  1. Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Münster

    Georg Driesch, Markus Burgmer & Gereon Heuft

  2. Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Domagkstraße 22, 48149, Münster

    Georg Driesch

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Driesch, G., Burgmer, M. & Heuft, G. Körperdysmorphe Störung. Nervenarzt 75, 917–931 (2004). https://doi.org/10.1007/s00115-004-1776-6

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