Anxiety and related disorders: body dysmorphic disorder with absent insight: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety and related disorders: body dysmorphic disorder with absent insight

Sample item

A 24-year-old man is completely convinced, with delusional intensity, that his nose is grotesque, although it is normal. He spends hours mirror-checking and camouflaging it and has no other psychotic symptoms. According to DSM-5, which diagnosis applies?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Body dysmorphic disorder with absent insight

In DSM-5, a person with body dysmorphic disorder whose belief is held with delusional conviction is still diagnosed with BDD, using the specifier 'with absent insight/delusional beliefs', and not with delusional disorder. SSRIs and CBT are the usual treatments.

Option by option

  • A. Illness anxiety disorder

    Illness anxiety disorder involves fear of having a serious disease, not a perceived appearance flaw.

  • B. Delusional disorder, somatic type

    DSM-5 reserves this diagnosis for cases that do not meet criteria for BDD.

  • C. Social anxiety disorder

    Social anxiety disorder is fear of scrutiny, not a fixed belief about a defect.

  • D. Body dysmorphic disorder with absent insight (correct)

    Correct. DSM-5 diagnoses BDD with the absent insight specifier even when the belief is delusional.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Body dysmorphic disorder with absent insight. In DSM-5, a person with body dysmorphic disorder whose belief is held with delusional conviction is still diagnosed with BDD, using the specifier 'with absent insight/delusional beliefs', and not with delusional disorder.

Why is "Illness anxiety disorder" not the answer?

Illness anxiety disorder involves fear of having a serious disease, not a perceived appearance flaw.

Why is "Delusional disorder, somatic type" not the answer?

DSM-5 reserves this diagnosis for cases that do not meet criteria for BDD.

Why is "Social anxiety disorder" not the answer?

Social anxiety disorder is fear of scrutiny, not a fixed belief about a defect.

What concept does this question test?

It tests Anxiety and related disorders: body dysmorphic disorder with absent insight in Psychiatry. SSRIs and CBT are the usual treatments.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety and related disorders: body dysmorphic disorder with absent insight?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.