Skip to main navigation menu Skip to main content Skip to site footer

No. 3 (2026)

DISCUSSION

The position of Russian experts on the interdisciplinary assessment of body dysmorphic disorder and body-focused repetitive behaviors as part of obsessive-compulsive spectrum disorders

https://doi.org/10.48612/psyph/agnx-bd2v-2bkg

Published 2026-10-02

  • A.S. Avedisova
    • ,
  • E.R. Araviyskaya
    • ,
  • L.S. Kruglova
    • ,
  • A.N. Lvov
    • ,
  • I.A. Martynikhin
    • ,
  • V.E. Medvedev
    • ,
  • V.D. Mendelevich
    • ,
  • D.S. Petelin
    • ,
  • S.S. Potanin
    • ,
  • M.A. Samushiya
    • ,
  • G.M. Usov
    • ,
  • S.N. Mosolov

A.S. Avedisova
V.P. Serbsky National Medical Research Centre of Psychiatry and Narcology

E.R. Araviyskaya
Pavlov First Saint Petersburg State Medical University

L.S. Kruglova
Central State Medical Academy of the Administrative Department of the President of the Russian Federation

A.N. Lvov
Central State Medical Academy of the Administrative Department of the President of the Russian Federation; Lomonosov Moscow State University

I.A. Martynikhin
Pavlov First Saint Petersburg State Medical University; Medical and Psychological Center "Reshenie"

V.E. Medvedev
Peoples' Friendship University of Russia named after Patrice Lumumba

V.D. Mendelevich
Kazan State Medical University

D.S. Petelin
First Moscow State Medical University named after I.M. Sechenov

S.S. Potanin
Moscow Medical University "REAVIZ"; "Neuro-Psi" Clinic of Modern Psychotherapy and Psychiatry

M.A. Samushiya
Central State Medical Academy of the Administrative Department of the President of the Russian Federation; Central Clinical Hospital with a Polyclinic of the Administrative Department of the President of the Russian Federation

G.M. Usov
Omsk State Medical University

S.N. Mosolov
V.P. Serbsky National Medical Research Centre of Psychiatry and Narcology; Russian Medical Academy of Continuous Professional Education

Abstract

This paper presents current data on the prevalence, clinical structure, relationship with obsessive-compulsive disorder, diagnosis, and treatment of body dysmorphic
disorder and body-focused repetitive behavior. It critically analyzes current trends in expanding the diagnosis of obsessive-compulsive disorder, narrowing the diagnostic
boundaries of delusional disorders, and distinguishing obsessive-compulsive disorder from delusions. Using models of both body dysmorphic disorder and body-focused
repetitive behavior, it demonstrates their high public health significance, significant prevalence, diagnostic difficulties, and the insufficient development of treatment
approaches. Based on the presented data, recommendations are provided for improving the care of patients with these two diagnoses.

Keywords

OCD, obsessive-compulsive spectrum disorders, body dysmorphic disorder, pathological body-focused repetitive behaviors, psychopharmacotherapy

PDF (Русский)

References

  1. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. – 5th ed. – Washington, DC: American Psychiatric Association, 2013. – 947 p.
  2. Pinciotti C.M., Riemann B.C., Abramowitz J.S. Intolerance of uncertainty and obsessive-compulsive disorder dimensions // Journal of Anxiety Disorders. – 2021. – Vol. 81. – Art. 102417. – https://doi.org/10.1016/j.janxdis.2021.10241
  3. Beucke J.C., Sepulcre J., Talukdar T. et al. Abnormally high degree connectivity of the orbitofrontal cortex in obsessive-compulsive disorder // JAMA Psychiatry. – 2013. – Vol. 70 (6). – Pp. 619–629. – https://doi.org/10.1001/jamapsychiatry.2013.173
  4. Bandelow B., Allgulander C., Baldwin D.S. et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. – Part I: Anxiety disorders // World Journal of Biological Psychiatry. – 2023. – Vol. 24 (2). – Pp. 79–117. – https://doi.org/10.1080/15622975.2022.2086295
  5. Dingemans A.E., Volkmer S.A., Mulkens S. et al. The obsessive-compulsive spectrum: A network analysis // Psychiatry Research. – 2022. – Vol. 308. – Art. 114351. – https://doi.org/10.1016/j.psychres.2021.114351
  6. Ravindran A.V., da Silva T.L., Ravindran L.N. et al. Obsessive-compulsive spectrum disorders: A review of the evidence-based treatments // Canadian Journal of Psychiatry. – 2009. – Vol. 54 (5). – Pp. 331–343. – https://doi.org/10.1177/070674370905400507
  7. Gaebel W., Stricker J., Kerst A. Changes from ICD-10 to ICD-11 and future directions in psychiatric classification // Dialogues in Clinical Neuroscience. – 2020. – Vol. 22 (1). – Pp. 7–15. – https://doi.org/10.31887/DCNS.2020.22.1/wgaebel
  8. Медведев В.Э. Дисморфическое расстройство: клиническая и нозологическая гетерогенность // Неврология, нейропсихиатрия, психосоматика. – 2016. – Т. 8, № 1. – С. 49–55. – https://doi.org/10.14412/2074-2711-2016-1-49-55
  9. Медведев В.Э. Дисморфическое расстройство: гетерогенные факторы риска и клинико-динамические характеристики // Психиатрия и психофармакотерапия. – 2021. – № 2. – С. 29–36.
  10. Pérez-Buenfil A., Morales-Sánchez A. Prevalence of body dysmorphic disorder: A systematic review and meta-analysis // J Cosmet Dermatol. – 2025. – Vol. 24 (4). – Art. 70121. – https://doi.org/10.1111/jocd.70121
  11. Krebs G., Clark B.R., Ford T.J. et al. Epidemiology of body dysmorphic disorder and appearance preoccupation in youth: Prevalence, comorbidity and psychosocial impairment // J Am Acad Child Adolesc Psychiatry. – 2025. – Vol. 64 (1). – Pp. 30–40. – https://doi.org/10.1016/j.jaac.2024.01.017
  12. Muzaffar K.H., Halilu H.B., Dantata B.A. et al. Prevalence of anxiety, depression, and body dysmorphic disorders among dermatology outpatients with acne vulgaris at a public hospital in Saudi Arabia // Cureus. – 2024. – Vol. 16 (7). – Art. e64917. – https://doi.org/10.7759/cureus.64917
  13. Sweis I.E., Spitz J., Barry D.R. Jr., Cohen M. A Review of body dysmorphic disorder in aesthetic surgery patients and the legal implications // Aesthetic Plastic Surgery. – 2017. – Vol. 41 (4). – Pp. 949–954. – https://doi.org/10.1007/s00266-017-0819-x
  14. Eskander N., Limbana T., Khan F. Psychiatric comorbidities and the risk of suicide in obsessive-compulsive and body dysmorphic disorder // Cureus. – 2020. – Vol. 12 (8). – Art. e9805. – https://doi.org/10.7759/cureus.9805
  15. Buhlmann U., Glaesmer H., Mewes R. et al. Updates on the prevalence of body dysmorphic disorder: A population-based survey // Psychiatry Research. – 2010. – Vol. 178 (1). – Pp. 171–175. – https://doi.org/10.1016/j.psychres.2009.05.002
  16. Rief W., Buhlmann U., Wilhelm S. et al. The prevalence of body dysmorphic disorder: A population-based survey // Psychological Medicine. – 2006. – Vol. 36 (6). – Pp. 877–885. – https://doi.org/10.1017/S0033291706007264
  17. Phillips K.A., Diaz S.F. Gender differences in body dysmorphic disorder // Journal of Nervous and Mental Disease. – 1997. – Vol. 185 (9). – Pp. 570–577. – https://doi.org/10.1097/00005053-199709000-00006
  18. Crerand C.E., Franklin M.E., Sarwer D.B. Body dysmorphic disorder and cosmetic surgery // Plastic and Reconstructive Surgery. – 2006. – Vol. 118 (7). – Pp. 167e–180e. – https://doi.org/10.1097/01.prs.0000242500.28431.24
  19. Sarwer D.B., Crerand C.E., Magee L. Body dysmorphic disorder in patients who seek appearance-enhancing medical treatments // Oral and Maxillofacial Surgery Clinics of North America. – 2010. – Vol. 22 (4). – Pp. 445–453. – https://doi.org/10.1016/j.coms.2010.07.002
  20. Sarwer D.B., Whitaker L.A. Psychology of plastic and reconstructive surgery: A systematic clinical review // Plastic and Reconstructive Surgery. – 2011. – Vol. 128 (3). – Pp. 827–828. – https://doi.org/10.1097/PRS.0b013e31822216de
  21. Hanley S.M., Bhullar N., Wootton B.M. Development and initial validation of the Body Dysmorphic Disorder Scale for Youth // Clinical Psychologist. – 2020. – Vol. 24 (3). – Pp. 254–266. – https://doi.org/10.1111/cp.12225
  22. Ishigooka J. et al. Demographic features of patients seeking cosmetic surgery // Psychiatry and Clinical Neurosciences. – 1998. – Vol. 52 (3). – Pp. 283–287. – https://doi.org/10.1046/j.1440-1819.1998.00388.x
  23. Pavan C., Vindigni V., Semenzin M. et al. Personality, temperament and clinical scales in an Italian Plastic Surgery setting: What about body dysmorphic disorder? // International Journal of Psychiatry in Clinical Practice. – 2006. – Vol. 10 (2). – Pp. 91–96. – https://doi.org/10.1080/13651500500487677
  24. Ribeiro R.V.E. Prevalence of body dysmorphic disorder in plastic surgery and dermatology patients: A systematic review with meta-analysis // Aesthetic Plastic Surgery. – 2017. – Vol. 41 (4). – Pp. 964–970. – https://doi.org/10.1007/s00266-017-0869-0
  25. Ross N.A., Todd Q., Saedi N. Patient seeking behaviors and online personas: Social media’s role in cosmetic dermatology // Dermatologic Surgery. – 2015. – Vol. 41 (2). – Pp. 269–276. – https://doi.org/10.1097/DSS.0000000000000267
  26. Phillips K.A., Menard W. Suicidality in body dysmorphic disorder: A prospective study // American Journal of Psychiatry. – 2006. – Vol. 163 (7). – Pp. 1280–1282. – https://doi.org/10.1176/ajp.2006.163.7.1280
  27. Didie E.R., Walters M.M., Pinto A. et al. A comparison of quality of life and psychosocial functioning in obsessive-compulsive disorder and body dysmorphic disorder // Annals of Clinical Psychiatry. – 2007. – Vol. 19 (3). – Pp. 181–186. – https://doi.org/10.1080/10401230701468685
  28. Fenwick A.S., Sullivan K.A. Potential link between body dysmorphic disorder symptoms and alexithymia in an eating-disordered treatment-seeking sample // Psychiatry Research. – 2011. – Vol. 189. – Pp. 299–304. – https://doi.org/10.1016/j.psychres.2011.07.011
  29. Sarwer D.B., Crerand C.E. Body image and cosmetic medical treatments // Body Image. – 2004. – Vol. 1 (1). – Pp. 99–111. – https://doi.org/10.1016/S1740-1445(03)00003-2
  30. Machremi E., Bakirtzis C., Karakasi M.V. et al. What scans see when patients see defects: Neuroimaging findings in body dysmorphic disorder // Journal of Integrative Neuroscience. – 2022. – Vol. 21 (2). – Art. 45. – https://doi.org/10.31083/j.jin2102045
  31. Moody T.D., Morfini F., Cheng G. et al. Brain activation and connectivity in anorexia nervosa and body dysmorphic disorder when viewing bodies: Relationships to clinical symptoms and perception of appearance // Brain Imaging and Behavior. – 2021. – Vol. 15 (3). – Pp. 1235–1252. – https://doi.org/10.1007/s11682-020-00323-5
  32. Minikowski G.C., Veiga D.F., Felix G.A.A. et al. Genital self-image and body dysmorphic symptoms in patients undergoing central wedge or linear labiaplasty: A clinical trial // Plastic and Reconstructive Surgery. – 2025. – Vol. 155 (1). – Pp. 53e–65e. – https://doi.org/10.1097/PRS.0000000000011534
  33. Phillips K.A. Understanding body dysmorphic disorder: An essential guide. – Oxford: Oxford University Press, 2009. – 320 p.
  34. Медведев В.Э., Сиволап Ю.П., Палин А.В. и др. Терапия дисморфического телесного расстройства у пациентов в эстетической медицине // Психиатрия и психофармакотерапия. – 2025. – Т. 27, № 5. – С. 22–29. – https://doi.org/10.62202/2075-1761-2025-27-5-22-29
  35. Граненов Г.М., Мосолов С.Н. Применение антидепрессантов различных групп при терапии обсессивно-компульсивных расстройств // Журнал неврологии и психиатрии имени С.С. Корсакова. – 2003. – № 7. – С. 70–76.
  36. Петелин Д., Аведисова А., Зайцев О. и др. Ведение пациентов с обсессивно-компульсивным расстройством: фокус на новые данные // Современная терапия психических расстройств. – 2025. – № 3. – С. 63–71. – https://doi.org/10.48612/psyph/ed2u-u3gu-gt4g
  37. Phillips K.A., Dwight M.M., McElroy S.L. Efficacy and safety of fluvoxamine in body dysmorphic disorder // Journal of Clinical Psychiatry. – 1998. – Vol. 59 (4). – Pp. 165–171. – https://doi.org/10.4088/jcp.v59n0404
  38. Медведев В.Э., Барсегян Т.В., Дробышев А.В. Терапия депрессивных и тревожных расстройств у пациентов, обращающихся за хирургической коррекцией внешности // Психическое здоровье. – 2012. – № 5 (72). – С. 40–45.
  39. Клинические рекомендации по терапии обсессивно-компульсивного расстройства. – Рубрикатор клинических рекомендаций Минздрава России, 2025. – URL: https://cr.minzdrav.gov.ru (дата обращения 07.07.2026).
  40. Мосолов С.Н., Аведисова А.С., Немкова Е.С. Особенности использования оригинального и воспроизведенного флувоксамина в клинической практике психиатров и неврологов для терапии депрессии (результаты опроса врачей) // Современная терапия психических расстройств. – 2025. – № 2. – С. 38–45. – https://doi.org/10.48612/psyph/zph4-2e1n-8h9r
  41. Grant J.E., Stein D.J. Body-focused repetitive behavior disorders in ICD-11 // Revista Brasileira de Psiquiatria. – 2014. – Vol. 36, Suppl. 1. – Pp. 59–64. – https://doi.org/10.1590/1516-4446-2013-1228
  42. Woods D.W., Houghton D.C. Evidence-based psychosocial treatments for pediatric body-focused repetitive behavior disorders // Journal of Clinical Child and Adolescent Psychology. – 2016. – Vol. 45 (3). – Pp. 227–240. – https://doi.org/10.1080/15374416.2015.1055860
  43. Christenson G.A., Mackenzie T.B., Mitchell J.E. Characteristics of 60 adult chronic hair pullers // American Journal of Psychiatry. – 1991. – Vol. 148 (3). – Pp. 365–370. – https://doi.org/10.1176/ajp.148.3.365
  44. Duke D.C., Keeley M.L., Geffken G.R., Storch E.A. Trichotillomania: A current review // Clinical Psychology Review. – 2009. – Vol. 29 (5). – Pp. 449–458. – https://doi.org/10.1016/j.cpr.2009.10.008
  45. Hayes S.L., Storch E.A., Berlanga L. Skin picking behaviors: an examination of the prevalence and severity in a community sample // Journal of Anxiety Disorders. – 2009. – Vol. 23 (3). – Pp. 314–319. – https://doi.org/10.1016/j.janxdis.2009.01.008
  46. Grant J.E., Odlaug B.L., Chamberlain S.R. A cognitive comparison of pathological skin picking and trichotillomania // Journal of Psychiatric Research. – 2011. – Vol. 45 (12). – Pp. 1634–1638. – https://doi.org/10.1016/j.jpsychires.2011.07.012
  47. Ghanizadeh A. Nail biting; etiology, consequences and management // Iranian Journal of Medical Sciences. – 2011. – Vol. 36 (2). – Pp. 73–79. – URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC3556753/
  48. Pacan P., Grzesiak M., Reich A., Szepietowski J.C. Onychophagia as a spectrum of obsessive-compulsive disorder // Acta Dermato-Venereologica. – 2014. – Vol. 94 (6). – Pp. 661–664. – https://doi.org/10.2340/00015555-0646
  49. Flessner C.A., Busch A.M., Heideman P.W., Woods D.W. Acceptance-enhanced behavior therapy (AEBT) for trichotillomania and chronic skin picking: Exploring the effects of component sequencing // Behavior Modification. – 2008. – Vol. 32 (5). – Pp. 579–594. – https://doi.org/10.1177/0145445507313800
  50. Chamberlain S.R., Odlaug B.L., Boulougouris V. et al. Trichotillomania: Neurobiology and treatment // Neuroscience & Biobehavioral Reviews. – 2018. – Vol. 45. – Pp. 159–170. – https://doi.org/10.1016/j.neubiorev.2009.02.002
  51. Odlaug B.L., Grant J.E. Pathologic skin picking // American Journal of Drug and Alcohol Abuse. – 2012. – Vol. 38 (5). – Pp. 393–398. – https://doi.org/10.3109/00952991003747543
  52. Tanaka O.M., Vitral R.W.F., Tanaka G.Y. et al. Nailbiting, or onychophagia: A special habit // American Journal of Orthodontics and Dentofacial Orthopedics. – 2008. – Vol. 134 (2). – Pp. 305–308. – https://doi.org/10.1016/j.ajodo.2006.06.023
  53. Sachan A., Chaturvedi T.P. Onychophagia (Nail biting), anxiety, and malocclusion // Indian Journal of Dental Research. – 2012. – Vol. 23 (5). – Pp. 680–682. – https://doi.org/10.4103/0970-9290.107399
  54. Carr J.R., Sholevar E.H., Baron D.A. Trichotillomania and trichobezoar: A clinical practice insight with report of illustrative case // The Journal of the American Osteopathic Association. – 2006. – Vol. 106 (11). – Pp. 647–652.
  55. Woods D.W., Flessner C.A., Franklin M.E. et al. The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization // Journal of Clinical Psychiatry. – 2006. – Vol. 67 (12). – Pp. 1877–1888. – https://doi.org/10.4088/jcp.v67n1207
  56. Odlaug B.L., Kim S.W., Grant J.E. Quality of life and clinical severity in pathological skin picking and trichotillomania // Journal of Anxiety Disorders. – 2012. – Vol. 26 (8). – Pp. 823–828. – https://doi.org/10.1016/j.janxdis.2010.06.004
  57. Flessner C.A., Woods D.W. Phenomenological characteristics, social problems, and the economic impact associated with chronic skin picking // Behavior Modification. – 2006. – Vol. 30 (6). – Pp. 944–963. – https://doi.org/10.1177/0145445506294083
  58. Grant J.E., Chamberlain S.R. Trichotillomania and skin-picking disorder: Different kinds of OCD // American Journal of Psychiatry. – 2016. – Vol. 173 (4). – Pp. 344–348. – https://doi.org/10.1176/appi.focus.130212
  59. Okumuş H.G., Akdemir D. Body focused repetitive behavior disorders: Behavioral models and neurobiological mechanisms // Turkish Journal of Psychiatry. – 2023. – Vol. 34 (1). – Pp. 50–59. – https://doi.org/10.5080/u26213

Downloads

Download data is not yet available.