Rapid Responses to:

NEWS EXTRA: Susan Mayor UK guidelines urge improved recognition of obsessive-compulsive disorder BMJ 2005; 331: 1228-a [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

How Many BDD Cases Go Undiagnoised?

Maurice E de Morton   (4 March 2006)

How Many BDD Cases Go Undiagnoised? 4 March 2006
Maurice E de Morton, Consulting Engineer 19 Pettys Lane Doncaster Victoria 3108 Australia Send response to journal: Re: How Many BDD Cases Go Undiagnoised?	The publication of the UK (NICE) guidelines for GP's to improve the detection of people with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD)is timely.In sugesting that patients are asked direct questions about possible symptoms such as "Do you wash or clean a lot?" or "Do you check things a lot?" or "Is there any thought that keeps bothering you that you would like to get rid of but can't?" are questions that should help to break through the normal reticience of sufferers of these disorders based on the shame or sense of guilt in admitting to unusual thoughts and behaviour. However, the presupposition is that GP's and even specialist's are fully cognizant of these disorders that may be present in not insignificant numbers, up to 2% of populations. Many sufferers will present and be treated for sometimes minor symptoms that may nevertheless be a source of acute mental suffering. A greater awareness is needed when patients persist in seeking treatment for outwardly minor symptoms, particularly BDD suffers. After having sought treatment and being cleared for minor psoriasis by two GP's and a specialist my 26 year old son quite unexpectedly took his own life last November after leaving a confidental, full and frank recording of his inner thoughts and behaviour which corresponded to classical published BDD symptoms. Subsequent discussion with the relevant medical practitioners revealed an alarming lack of appreciation of the mentally painful and potentially life threatening BDD disorder that was underlying his minor physical symptoms. Consideration of patients underlying stressful situation and quality of life may well allieviate all round suffering in the community. Competing interests: None declared