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J Psychosom Res. 2011 Mar;70(3):286-93. doi: 10.1016/j.jpsychores.2010.10.002. Epub 2010 Dec 16.

Treatment utilization and barriers to treatment engagement among people with body dysmorphic symptoms.

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Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.



Body dysmorphic disorder (BDD) is characterized by an excessive preoccupation with an imagined or minor appearance flaw. Many aspects of BDD remain unknown, such as rates of treatment utilization, types of treatment sought, and barriers to treatment. The present study sought to examine rates and patterns of treatment utilization as well as barriers to treatment among individuals with body dysmorphic symptoms.


The present study consists of 401 individuals with symptoms consistent with a diagnosis of BDD who completed self-reported measures of treatment utilization and barriers to treatment in an internet survey.


Consistent with past research, results showed that individuals with probable BDD reported seeking non-mental health treatments for BDD (e.g., plastic surgery). Additionally, an examination of treatment barriers demonstrated significant barriers for the sample for the three domains examined: logistic and financial; stigma, shame, and discrimination; and treatment skepticism. Secondary analyses revealed a differential endorsement of treatment barriers across ethnic groups for all three barrier domains.


These data suggest that BDD is still an underrecognized disorder with marked barriers to treatment. Increased education and dissemination efforts are warranted.

[Indexed for MEDLINE]

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