Quasimodo syndrome: Understanding modern body dysmorphic disorder

Quasimodo is a character from Victor Hugo's novel "The Hunchback of Notre Dame." Many people also recognize this character from the popular Walt Disney animation. Quasimodo, known for his terrible physical appearance, embodies ugliness and a good heart. What connects this character to the increasingly common body dysmorphic disorder? Do patients suffering from this condition resemble the fictional hunchback? Quite the opposite! Body dysmorphic disorder, also known as Quasimodo Syndrome, is a mental problem, not a physical one.

According to data published in the World Health Organization (WHO) report, mental or neurological disorders may occur at some stage of life in every fourth person living on Earth. Quasimodo Syndrome affects people of various ages and both sexes, although women are more frequently affected. Currently, it is estimated that this problem already affects about 2 percent of the entire population. What is it about, and how does it manifest?

The term "dysmorphia" comes from the Greek language and means ugliness, primarily of the face. Indeed, this part of the body is strongly associated with the symptoms of the disease. People affected by the disease are obsessed with imagined or almost invisible imperfections on their faces and other parts of their bodies. Although their focus can include any body part, they are most concerned with the visible ones, such as the face, hair, and skin. Their worries predominantly revolve around skin conditions (freckles, acne, discoloration, enlarged blood vessels), facial features, nose appearance, hair colour, density and type, weight, figure, or body proportions.

This morbid obsession disrupts normal daily functioning. The patient is so focused on their perceived flaws that they cannot accept their appearance. Even though others don't see any defect on the patient's face or body, the patient perceives themselves very critically. No arguments can convince them that such a defect simply does not exist or is not a flaw.

Quasimodo Syndrome primarily manifests through a negative self-assessment of one's appearance, which has no reflection in reality. The patient is focused on their flaws, around which their world revolves. They constantly compare their imperfections with others, causing problems in concentrating on other matters. Together with low self-esteem, this leads to anxiety in social situations, and consequently, they increasingly withdraw from their surroundings, avoiding close ones and friends.

Other symptoms of dysmorphophobia include compulsive behaviours, such as skin picking, and various gestures and activities aiming to hide flaws. This includes obsessive mirror-checking or avoidance, frequent changing of clothing, excessive grooming, or undergoing multiple plastic surgeries.

This serious disorder usually appears in young girls during puberty. This is a crucial time when a young person's self-esteem is formed, role models are chosen, and their perception of the world becomes clearer. Many factors influence the development of this disease. Genetic predispositions, hormones, disturbed self-esteem, personality traits (such as hypersensitivity, tendency to exaggerate, or over-detailing), social norms, and perceptions of beauty via standards spread on social media are all significant.

People suffering from dysmorphia require treatment, which can be achieved using various methods. Sometimes, different treatment methods should be combined to enhance the effects of therapy. It is crucial to tailor the treatment to the individual needs of the patient. Many experts believe that the first stage of treatment is psychological consultation and care. Intensive psychotherapy, focusing on cognitive-behavioural therapy, is often recommended. During such sessions, the therapist focuses on building the patient's identity, self-esteem, sense of worth, etc.

Another treatment method is the administration of medications, such as antidepressants, which reduce obsessive thoughts and compulsive behaviours and also raise serotonin levels (a neurotransmitter responsible for well-being, sleep, mood, and other processes in the body).