Appearance, body image and distress in facial dysmorphophobia.

Compared with surgical patients awaiting rhinoplasty and control subjects, dysmorphophobic patients were more dissatisfied with facial appearance, more anxious, more depressed, more neurotic and less extrovert. Morphanalysis, an objective measure of facial appearance, was applied to the first 11 dysmorphophobic and first 11 surgical subjects. The dysmorphophobic group had a variety of abnormal features that were not identified by medical practitioners or the patient. These subtle anomalies were often unrelated to the focus of dissatisfaction which was usually normal. A panel of lay judges rated the appearance of the dysmorphophobic group as being intermediate between the control and surgical groups but not significantly different from either.