When working with patients, health professionals often refer to clinical diagnostic manuals to better understand the patient’s illness and potential treatment.
There are two main recognised diagnostic manuals commonly used around the world today. These are the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Whilst both manuals generally tend to complement each other, there are differences in the descriptions they use. Here in the UK (England and Wales only), in addition to the ICD-10 and the DSM-5, the National Institute for Health and Clinical Excellence (NICE) launched their own set of clinical guidelines for the identification, treatment and management of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder in 2005.
You can read a summary of both the ICD and DSM on our clinical classification of OCD page. On this page we will summarise what both diagnostic manuals say about BDD.
At present the International Classification of Diseases (ICD) currently lists BDD under the Hypochondriacal disorder listed within the sub-category of Somatoform Disorders which sits under the category of Neurotic, Stress-related and Somatoform Disorders alongside other anxiety disorders including OCD, all of which sits inside the mental and behavioural disorders category.
The is how each of those top two tier categories are listed:
Mental and behavioural disorders (F00-F99)
Incl: disorders of psychological development
- F00-F09 – Organic, including symptomatic, mental disorders
- F10-F19 – Mental and behavioural disorders due to psychoactive substance use
- F20-F29 – Schizophrenia, schizotypal and delusional disorders
- F30-F39 – Mood [affective] disorders
- F40-F48 – Neurotic, stress-related and somatoform disorders
- F50-F59 – Behavioural syndromes associated with physiological disturbances and physical factors
- F60-F69 – Disorders of adult personality and behaviour
- F70-F79 – Mental retardation
- F80-F89 – Disorders of psychological development
- F90-F98 – Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
- F99-F99 – Unspecified mental disorder
So OCD is listed under F40-F48 – Neurotic, stress-related and somatoform disorders (F40-F48), a category which includes:
- F40 – Phobic anxiety disorders including Agoraphobia, Social phobias, Specific (isolated) phobias, Other phobic anxiety disorders.
- F41 – Other anxiety disorders including Panic disorder, Generalized anxiety disorder, Mixed anxiety and depressive disorder, Other mixed anxiety disorders.
- F42 – Obsessive-compulsive disorder (see below).
- F43 – Reaction to severe stress, and adjustment disorders including Acute stress reaction, Post-traumatic stress disorder, Adjustment disorders.
- F44 – Dissociative [conversion] disorders including Dissociative amnesia, Dissociative fugue, Dissociative stupor, Trance and possession disorders, Dissociative motor disorders, Dissociative convulsions, Dissociative anaesthesia and sensory loss, Other dissociative [conversion] disorders.
- F45 – Somatoform disorders including Somatization disorder, Hypochondriacal disorder, Somatoform autonomic dysfunction, Persistent somatoform pain disorder, Other somatoform disorders.
- F48 – Other neurotic disorders including Neurasthenia Depersonalization-derealization syndrome, Other specified neurotic disorders.
With regard to the essential features of OCD, the ICD-10 manual (2016) states the following diagnostic criteria for Obsessive-Compulsive Disorder.
(Code: F45.2) Hypochondriacal disorder
The essential feature is a persistent preoccupation with the possibility of having one or more serious and progressive physical disorders. Patients manifest persistent somatic complaints or a persistent preoccupation with their physical appearance. Normal or commonplace sensations and appearances are often interpreted by patients as abnormal and distressing, and attention is usually focused upon only one or two organs or systems of the body. Marked depression and anxiety are often present, and may justify additional diagnoses.
- Body dysmorphic disorder
- Dysmorphophobia (nondelusional)
- Hypochondriacal neurosis
Excl: delusional dysmorphophobia (F22.8), fixed delusions about bodily functions or shape (F22.)
What to read next: