Practitioner Review: Assessment and treatment of body dysmorphic disorder in young people
Open accessAbstract
Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under‐recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long‐term consequences and treatment.
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Adolescents with BDD frequently experience co-occurring conditions such as major depressive disorder, OCD, anxiety disorders, and eating disorders.
“Adolescents with BDD frequently experience co-occurring conditions such as MDD, OCD, anxiety disorders, and eating disorders [120].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [120]
The comorbidity section (p. 4) says approximately 70% of young people with BDD have an additional diagnosis and identifies depressive disorders, social anxiety disorder, and eating disorders as particularly common. Initial assessment (p. 5) also names OCD as a common co-occurring disorder. The paper says depression or depressive disorders, but does not specifically identify major depressive disorder (MDD). (LLM, conf=0.85)
Experimental — accuracy not yet measuredUntreated BDD often follows a chronic trajectory, increasing the risk of severe distress, functional impairment, and suicidality.
“The disorder is frequently underdiagnosed due to limited clinical awareness and stigma, and untreated cases often follow a chronic trajectory, increasing the risk of severe distress, functional impairment, and suicidality [120].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [120]
The review reports that BDD is underdiagnosed partly because of limited clinician awareness and reluctance to disclose symptoms (screening and assessment, p. 5). It also describes substantial impairment and suicide risk in young people with BDD (Introduction, p. 1; impact and comorbidity, pp. 2–4). It does not establish that untreated cases often follow a chronic course or that remaining untreated increases those risks. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBDD is frequently underdiagnosed due to limited clinical awareness and stigma.
“The disorder is frequently underdiagnosed due to limited clinical awareness and stigma, and untreated cases often follow a chronic trajectory, increasing the risk of severe distress, functional impairment, and suicidality [120].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [120]
BDD is often mistaken for typical adolescent body image concerns, leading to delays in diagnosis and treatment.
“The disorder is often mistaken for typical adolescent body image concerns, leading to delays in diagnosis and treatment [120].”
From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [120]
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Cites
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Self-citationA critical review of cosmetic treatment outcomes in body dysmorphic disorder
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The Impact of Social Media & Technology on Child and Adolescent Mental Health
Masri-zada, T., Martirosyan, S., Abdou, A., Barbar, R., Kades, S., Makki, H., Haley, G., & K Agrawal, D. (2025) · Journal of Psychiatry and Psychiatric Disorders · doi:10.26502/jppd.2572-519x0242 · Cited by 45 · see citing works
- Authors
- Krebs, G., Rautio, D., Fernández de la Cruz, L., Hartmann, A. S., Jassi, A., Martin, A., Stringaris, A., & Mataix‐Cols, D.
- Affiliations
- South London and Maudsley NHS Foundation Trust (GB)
- Region Stockholm (SE)
- Centre for Psychiatry Research, Department of Clinical Neuroscience Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm Stockholm Sweden
- University of Konstanz (DE)
- University of Wuppertal (DE)
- National and Kapodistrian University of Athens (GR)
- Lund University (SE)
- Corresponding author
- Krebs, Georgina
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2024-05-08
- Volume
- 65
- Issue
- 8
- Pages
- 1119-1131
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W4396744244
- Cited by
- 14
- References
- 13
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 3
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- KOPS (University of Konstanz) (submittedVersion, cc-by)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- body dysmorphic disorder, adolescents, child and adolescent mental health services, etiology, genetic and environmental factors, screening evaluation, cognitive behavioral therapy, selective serotonin reuptake inhibitors, underdiagnosis, treatment outcomes
- MeSH terms
- Adolescent, Child, Humans, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors, Body Dysmorphic Disorders
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