Key words: body dysmorphic disorder, autism, mannerism, schizophrenic spectrum appearance, borderline personality disorder
The “Body Dysmorphic Disorder” is included in DSM-5, in the chapter “Obsessive-Compulsive and Related Disorder”, which contemplates different degrees of insight until the presence of delusional belief. This disorder is observed more often in dermatological, cosmetic surgery and orthodontic patients than in psychiatric patients. However, its prevalence in different psychiatric disorders, from anorexia to schizophrenia, is quite relevant, even though underestimated.
Starting from a short term clinical observation of a case of “Body dysmorphic Disorder” in a twenty years old nice girl in the course of a psychotic breakdown, the author discusses the psychopathological meaning of the disorder referring to the wrongly forgotten concepts of mannerism and autism (in its traditional adult psychiatry meanings).
In its more serious form, the “psychopathology of appearance” configures a disturbance of inter-subjectivity that precludes the patient from concrete and effective social relationships. The psychopathological analysis shows how the manneristic mask hides completely all the subjective experiences of the patient and her ability to talk about them, at the risk of a complete disconnection with the external world, a condition that can be defined as “autistic” in bleulerian meaning.
