A 26-year-old single man is brought in by his family because he has been refusing to leave his home for 3 months. The reason given by the patient is the belief that he has an asymmetrical jaw and a crooked face. According to the patient, this situation is progressive and he looks more and more deformed when he looks in the mirror. He is ashamed of his appearance, so he does not want to go out, he gets very anxious when he sees his image and he cannot stop thinking about his deformity all day long. He has consulted several maxillofacial surgeons but they tell him that he does not have facial asymmetry and refer him to a psychiatrist. The patient's diagnosis is:
Another simple question with an immediate answer, which offers no doubt. It describes a patient worried about a non-existent physical defect, whose concern distresses him and prevents him from leaving the house. As a psychiatry resident, I wish the MIR questions in my specialty were a bit more thought-provoking and in-depth, although I know that the seconds you will have saved by marking the fourth one directly are very valuable.
Major depressive disorder with delusional ideas incongruent with mood.
Obsessive-compulsive disorder.
Paranoid schizophrenia.
Body dysmorphic disorder.
It describes a patient worried about a non-existent physical defect, whose concern distresses him and prevents him from leaving the house.