Issues to explore~Body Dysmorphia~ Case study 1~ 16 year old male

The Mirror Lies: Body Dysmorphic Disorder

Taken from the website:

http://www.aafp.org/afp/2008/0715/p217.html

CASE STUDY

Demetrius is a 16-year-old Greek-American male who was admitted to the adolescent inpatient unit following an automobile collision. Demetrius has a history of major depression, school absences, and declining grades. His depression began at the onset of puberty. He reported that his automobile crash was not intentional, but that he was looking at his nose and acne in the rearview mirror when he lost control of his car on the freeway. No one else was with him; he has no friends and prefers to stay at home with his parents because he feels that his nose is hideous. He has never dated, avoids school functions, does not participate in sports, and believes that others laugh at the size of his nose. Demetrius is six feet tall, lanky, and thin. He has a full head of curly brown hair, a large nose, severe acne, and a pleasant demeanor.

While on the adolescent psychiatric unit, Demetrius spent a lot of time in the bathroom picking at his face, looking at his nose in reflective surfaces, and trying to manipulate his way out of group activities. He often had his hand over his nose and insisted on wearing a large hat and glasses on field trips. In spite of these behaviors, he was well-liked by others on the unit. Dermatology was consulted and his acne improved. Later that year, he had a rhinoplasty and his outlook was more positive. Two years later, he was readmitted following a suicide attempt after a breakup with his first girlfriend. At the second admission, he became convinced that he would be more appealing to women if he had cosmetic dentistry and began a bodybuilding regimen to achieve more definition of the muscles in his arms. At a five-year follow-up, Demetrius had quit high school and was living at home with his parents, not working, and on psychiatric disability.

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