title: Legal and medical aspects of body dysmorphic disorder.
abstract: Body Dysmorphic Disorder (BDD), a preoccupation with an imagined defect in physical appearance has a rich clinical history, but officially appeared with diagnostic criteria only in the DSM-III-R classification system. Prevalence of BDD in plastic and cosmetic dermatology ranges between 7-15% due to the obsession with imagined imperfections. The emotional "defect" causes dissatisfaction with nonpsychiatric medical procedures, and often recourse into legal action. We present a case study of BDD developing after cosmetic surgery and debate whether this is an actual possibility and the legal consequences of this possibility. We question whether surgery was a traumatic event and its relationship to the patient's premorbid "eggshell personality". The difficulty in determining causation of psychiatric disorders for the purpose of deciding issues of compensation is discussed. A practical algorithm is offered in order to avoid litigation and to maintain the legitimate medical ideal of "first do no harm".
authors.affiliation: Beer Yaakov Mental Health Centre, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Nachshoni
authors.forename: Moshe
authors.initials: M
authors.lastname: Kotler
mesh_terms: D000328:Adult; D001828:Body Image; D006801:Humans; D007557:Israel; D008297:Male; D012649:Self Concept; D013001:Somatoform Disorders / Q000209:etiology / Q000523:psychology*; D013518:Surgery, Plastic / Q000331:legislation & jurisprudence* / Q000523:psychology