Body dysmorphic disorder: the distress of imagined ugliness

Article Abstract:

People who are preoccupied with an imagined defect in their physical appearance may be suffering from a psychiatric condition called body dysmorphic disorder, which has been recognized for a long time but is still poorly understood. Because it is not widely diagnosed, especially in the US, body dysmorphic disorder may be more common than is thought. Often causing severe psychosocial distress, it may be treatable with certain types of antidepressants and psychotherapy. Body dysmorphic disorder is a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R). It is characterized by an essentially normal person who is preoccupied with an imagined defect in his or her physical appearance. An example would be acute distress over imagining oneself to have an excessively large nose. Patients feel that the supposed abnormality is unbearably ugly. Body dysmorphic disorder can lead to social withdrawal and isolation and repeated visits to health care providers - especially dermatologists and plastic surgeons. The syndrome has long been described in the European, Russian, and Japanese literature under various names. It was rarely mentioned in US literature, however, hence its absence from diagnostic manuals until 1987. The present article reviews the literature on body dysmorphic disorder. It is suggested that the disorder is most commonly associated with a psychiatric diagnosis of depression, and can lead to social isolation, problems at work, unnecessary plastic surgery, and suicide. Treatment is not definitive as of yet, though drug therapy with serotonergic antidepressants has demonstrated some success. It is unclear whether body dysmorphic disorder is related to other psychiatric disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Body image, Self-perception, Self perception, Ugliness

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Imipramine and alprazolam treatment of lactate-induced acute endogenous distress in nonhuman primates

Article Abstract:

Differences in the treatment of panic disorders and other anxiety disorders are the result of clinical distinctions that have been made between the two conditions. Sodium lactate is frequently used in experiments to induce panic reactions in subjects with panic disorder to evaluate drug therapy for the condition. The subsequent treatment of these attacks with drug therapy has been found to be successful. The responses of 10 macaque monkeys were evaluated to compare the relative effectiveness of imipramine and alprazolam in treating induced panic attacks. Alprazolam is a benzodiazepine derivative which has been used as an alternative treatment to tricyclic antidepressants. Imipramine, a tricyclic antidepressant, has been used to treat panic disorders. The subjects were given doses of sodium lactate and an acute distress reaction ensued. The monkeys were then treated with imipramine, alprazolam, or a placebo. The distress response was blocked in all the monkeys that were given either of the two drugs. However, only alprazolam controlled the conditioned anxiety responses that developed in the subjects in addition to the panic episodes. The monkeys that were given alprazolam were visibly more sedate than the others. Although precautions were taken to gradually reduce the dose of alprazolam, the group experienced withdrawal symptoms. No withdrawal symptoms were observed in the group that took imipramine or placebo. Further studies are being conducted using this primate experimental model to ascertain the effects of a combination of different therapeutic agents upon induced panic attacks.

Models, Evaluation, Drug therapy, Panic disorders, Imipramine, Panic disorder, Alprazolam

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Correlates of psychiatric distress among wives of hemophilic men with and without HIV infection

Article Abstract:

Infection with the human immunodeficiency virus (HIV) can have a major negative effect on mental health. HIV infection can lead to neurological damage and the development of chronic stress, both of which can result in psychological problems. Psychological distress has been examined in persons infected with HIV, but few studies have examined its effect on their partners. This study examined psychological distress among the wives of hemophilic men. Psychological and sociodemographic data were obtained for 36 wives, of whom 17 had a husband who was HIV-positive. The wives were categorized into four groups, based upon the following characteristics of the spouse: HIV status, the stage of HIV infection, and severity of hemophilia. Symptoms of psychological distress did not differ among the four groups and were similar in all four groups to those of a normal population, indicating no general increase in distress among the subjects as a whole. Clinically meaningful distress levels were measured in five wives (29 percent) whose husbands were infected with HIV and in seven wives (37 percent) whose husbands were not infected. Variables that did correlate with increased symptoms of distress included the woman's fear of contracting AIDS, the way her husband coped with his illness, a perception of greater marital strain, and problems in other areas of life. These results indicate that HIV infection of a partner is not a direct cause of psychiatric stress, but it can be an indirect source of such stress. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Caregivers, HIV infection, HIV infections, Hemophilia, Family, AIDS (Disease), Hemophiliacs

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