Objective. A case is presented of body dysmorphic disorder, and a possibility is highlighted of a faulty diagnosis leading to therapeutic failure.
Case. In the course of clinical observation of a 28-year-old patient referred with a tentative diagnosis of paranoid schizophrenia, psychotic process was excluded and attention was drawn to the dysmorphic nature of his disorder. Since the age of 24 he had withdrawn from social relations, quit his job and used to spend time pondering on his appearance. He developed thinking disorders of delusional type. No symptom amelioration has been attained in pharmacotherapy provided so far.
Commentary. The onset of body dysmorphic disorder, even in a delusional form, should alert clinicians. Clinical evidence and research findings suggest that in cases of body dysmorphic disorder (BDD) selective serotonin reuptake inhibitors (SSRI) should be administered as the medication of choice. 1n the treatment of BDD any beneficial effects of neuroleptics remain uncertain.