Question

A middle-aged man has been referred to your office by a plastic surgeon. The man is seeking a face lift for his "excessively large cheeks." The surgeon has not been able to find anything abnormal about the man's face or skin, and when he comes to see you, you fail to see anything wrong either. The patient insists that his cheeks are grotesque and ruining his whole appearance. When pressed, he admits that others may not consider his cheeks to be as bad as he does. His most likely diagnosis is:

A. Malingering
B. Schizophrenia
C. Somatic symptom disorder
D. Conversion disorder (functional neurological symptom disorder)
E. Body dysmorphic disorder

Answer 1

A man who believes his cheeks are 'excessively large' and is seeking a face lift, despite no abnormal findings from health professionals, is most likely diagnosed with Body Dysmorphic Disorder (BDD).

Step-by-step explanation:

The middle-aged man seeking a face lift from a plastic surgeon due to his belief that his cheeks are 'excessively large' is most likely suffering from Body Dysmorphic Disorder (BDD). Considering the information provided, he perceives a flaw in his appearance that seems negligible or non-existent to others and to health professionals, which is a hallmark symptom of BDD. This psychological condition involves a preoccupation with imagined or exaggerated defects in one's physical appearance, leading individuals to seek cosmetic procedures.

Somatic symptom disorder involves a focus on physical symptoms that cause distress. Schizophrenia involves a range of symptoms including delusions and hallucinations, whereas conversion disorder involves neurological symptoms without a medical cause, different from this case. Malingering involves faking illness for personal gain, which does not seem to be the case here.