Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11.
The article reviews the historical background and symptoms of body dysmorphic disorder (BDD) and olfactory reference disorder, and describes the proposals of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders related to these categories. This paper examines the possible classification of BDD symptoms in ICD-10. Four different possible diagnoses are found (hypochondriacal disorder, schizotypal disorder, delusional disorder, or other persistent delusional disorder). This has led to significant confusion and lack of clear identification in ICD-10. Olfactory reference disorder can also be classified as a delusional disorder in ICD-10, but there is no diagnosis for non-delusional cases. The Working Group reviewed the classification and diagnostic criteria of BDD in DSM-5, as well as cultural variations of BDD and olfactory reference disorder that include Taijin Kyofusho. The Working Group has proposed the inclusion of both BDD and olfactory reference disorder in ICD-11, and has provided diagnostic guidelines and guidance on differential diagnosis. The Working Group's proposals for ICD-11 related to BDD and olfactory reference disorder are consistent with available global evidence and current understanding of common mechanisms in obsessive-compulsive and related disorders, and resolve considerable confusion inherent in ICD-10. The proposals explicitly recognize cultural factors. They are intended to improve clinical utility related to appropriate identification, treatment, and resource allocation related to these disorders.
Institute of Psychiatry and South London and Maudsley NHS Trust, London, UK.
David
D
Veale
Department of Neuropsychiatry, Hyogo College of Medicine, Japan.
Hisato
H
Matsunaga
D057215:Body Dysmorphic Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis*