Write an Article 2 pages Patient is 21 years old with history of bipolar disorder and dysmorphic. She has past history of sexual abuse from parents and by some other women her parents brought into the house. Patient was also raped by a staff member during her inpatient hospitalization. on diagnosis of dysmorphic disorder. Use minimum of three references. 1. The courses of dysmorphic 2. Risk factor 3. Symptoms 4. complication Treatment

Title: The Course, Risk Factors, Symptoms, and Complications of Dysmorphic Disorder in Patients with a History of Bipolar Disorder and Trauma

Introduction:
Dysmorphic disorder, also known as body dysmorphic disorder (BDD), is a psychiatric condition characterized by excessive preoccupation with perceived defects or flaws in one’s appearance. This disorder frequently co-occurs with other psychiatric conditions, such as bipolar disorder, and can be further complicated by a history of trauma, including sexual abuse. This article aims to provide an overview of the course, risk factors, symptoms, and complications of dysmorphic disorder in patients with a history of bipolar disorder and trauma.

The Course of Dysmorphic Disorder:
Dysmorphic disorder typically starts in adolescence or early adulthood and follows a chronic course if left untreated. Studies have shown that the severity of symptoms can fluctuate over time, with periods of remission and exacerbation. However, the majority of individuals with dysmorphic disorder experience chronic distress related to their perceived physical defects or flaws.

Risk Factors:
1. Genetic Factors: Research suggests a genetic component to dysmorphic disorder, with a higher prevalence observed in individuals with a family history of the disorder or other psychiatric conditions.
2. Environmental Factors: Traumatic experiences, such as childhood sexual abuse, have been associated with the development of dysmorphic disorder. Abuse can lead to body image disturbances and contribute to the onset and maintenance of the disorder.
3. Neurobiological Factors: Dysfunctions in brain regions involved in emotional regulation, such as the amygdala and prefrontal cortex, have been implicated in dysmorphic disorder. These neurobiological abnormalities may contribute to the heightened emotional reactivity and distorted body image perceived by individuals with the disorder.

Symptoms:
1. Preoccupation with Appearance: Individuals with dysmorphic disorder obsessively focus on perceived defects or flaws, which are often not noticeable or appear trivial to others.
2. Body Checking and Avoidance Behaviors: Patients frequently engage in repetitive behaviors, such as mirror checking, excessive grooming, or camouflaging techniques, to hide or fix perceived flaws. They may also avoid social situations to prevent perceived scrutiny.
3. Distress and Impairment: Dysmorphic disorder causes significant distress and impairment in functioning, leading to difficulties in various domains of life, including relationships, work, and social interactions.
4. Comorbidities: Patients with dysmorphic disorder often present with comorbid psychiatric conditions, including depression, anxiety disorders, substance abuse, and bipolar disorder.

Complications:
1. Suicidal Ideation and Attempts: Dysmorphic disorder is associated with a high risk of suicidal ideation and attempts. Studies have shown that up to 80% of individuals with dysmorphic disorder have a history of suicidal ideation, and around 25% have attempted suicide.
2. Impaired Quality of Life: The distress and impairment caused by dysmorphic disorder can significantly reduce an individual’s quality of life. Patients may experience difficulties in interpersonal relationships, academic or occupational performance, and overall well-being.
3. Functional Decline: In severe cases, dysmorphic disorder can lead to functional decline and disability. Individuals may struggle to maintain employment, attend educational institutions, or engage in social activities due to the preoccupation with perceived physical flaws.

Treatment:
1. Cognitive-Behavioral Therapy (CBT): CBT is the first-line treatment for dysmorphic disorder and has shown promising results in reducing symptoms and improving quality of life. CBT focuses on challenging and modifying distorted beliefs about one’s appearance, as well as reducing body checking and avoidance behaviors.
2. Medication: Selective serotonin reuptake inhibitors (SSRIs) have been found to be effective in reducing symptoms of dysmorphic disorder, particularly if comorbid depressive or anxiety symptoms are present.
3. Supportive Psychotherapy: Individual or group psychotherapy can provide support, validation, and normalization of experiences for individuals with dysmorphic disorder. Peer support groups can also be beneficial in reducing isolation and providing a sense of community.
4. Additional Approaches: Other treatment modalities, such as mindfulness-based therapies, psychodynamic psychotherapy, and family therapy, may be considered based on individual needs and preferences.

Conclusion:
Dysmorphic disorder can be a debilitating condition, especially when occurring in patients with a history of bipolar disorder and trauma. Understanding the course, risk factors, symptoms, and complications of this disorder is crucial for accurate diagnosis and appropriate treatment planning. A multimodal approach involving psychotherapy, medication, and supportive interventions can significantly improve symptoms and enhance the overall well-being of individuals with dysmorphic disorder.