World · Qatar NowPeople with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) could be identified earlier and offered more appropriate treatment under draft NICE guidance published today. The draft guideline introduces new recommendations to help healthcare professionals recognise OCD and BDD more consistently, particularly in people whose symptoms may be mistaken for other conditions or go unnoticed for years because of stigma, shame or limited information. The independent guideline committee said earlier identification could help more people access the support they need before their symptoms become severe.
The draft recommendations advise healthcare professionals to consider assessing for OCD or BDD in people with depression, anxiety, autism or ADHD, as well as in people seeking cosmetic procedures. The committee said symptoms can sometimes be overlooked, misunderstood or attributed to other conditions, contributing to delays in diagnosis and treatment. OCD affects an estimated 1.2% of the population.
People with OCD experience unwanted and distressing thoughts, images, urges or doubts that can feel impossible to ignore. To try to relieve the anxiety these thoughts cause, they may carry out repetitive behaviours or mental rituals, such as repeatedly checking, washing, counting or seeking reassurance. Symptoms are often hidden because of shame, embarrassment or fear of being misunderstood, meaning many people do not receive the right diagnosis or treatment until their condition becomes severe.
BDD is a mental health condition in which a person becomes excessively preoccupied with perceived flaws in their appearance. These concerns can cause significant distress and interfere with daily life. Research suggests BDD affects around 2% of adults in the wider population.
People with obsessive-compulsive disorder and body dysmorphic disorder can experience symptoms for a long time before they receive the right diagnosis and support. These conditions are often misunderstood, and many people find them difficult to talk about because of embarrassment, shame or fear of being judged. Eric Power, interim director of the Centre for Guidelines at NICE Mr Power added: "People with obsessive-compulsive disorder and body dysmorphic disorder can experience symptoms for a long time before they receive the right diagnosis and support.
These conditions are often misunderstood, and many people find them difficult to talk about because of embarrassment, shame or fear of being judged. "Our draft recommendations aim to help healthcare professionals recognise symptoms earlier, ask the right questions and support people to access appropriate treatment sooner. "Earlier identification can help ensure people receive care that reflects their needs, preferences and circumstances, rather than waiting until symptoms become more severe or reach crisis point." The draft guideline also introduces a new personalised, or "matched care", approach to treatment for OCD.
Rather than requiring people to progress through a fixed sequence of interventions, healthcare professionals would be encouraged to offer treatments based on an individual's clinical needs, treatment history and preferences from the outset. The committee concluded that treatment decisions should be tailored to the person rather than determined by a predefined stepped pathway. For children and young people with OCD, the draft guideline recommends family-based cognitive behavioural therapy as the most appropriate treatment option for many patients, recognising the important role that parents and carers can play in supporting recovery.
The draft recommendations also include measures designed to improve identification of BDD among people seeking cosmetic procedures. Healthcare professionals providing cosmetic treatments, including surgeons, dentists and dermatologists, would be advised to ask structured questions about appearance-related concerns and document their findings. If responses indicate that a person may have BDD, the draft guideline recommends referral for specialist assessment rather than proceeding with the procedure at that stage.
The committee noted that cosmetic procedures rarely improve the underlying condition and may sometimes worsen symptoms. Research suggests that BDD may be particularly common among people seeking cosmetic treatment. A 2024 systematic review and meta-analysis estimated that 18.6% of people attending aesthetic and reconstructive plastic surgery services had clinically significant BDD symptoms, compared with an estimated prevalence of around 2% in the wider adult population.
People, healthcare professionals and organisations are encouraged to take part in the consultation on the draft guideline , which is open until 21 October 2026.
Source: Wired-Gov
