Enrico Morselli and the Invention of Dysmorphophobia

Abstract

The Italian alienist Enrico Agostino Morselli (1852–1929) wrote many scientific articles and books on clinical and forensic psychiatry, experimental psychology, sociology, and anthropology. However, in the history of psychiatry, he is primarily known for having coined, in 1891, the word dysmorphophobia to describe a morbid condition in which a person is afflicted by the preoccupation with some imagined or negligible imperfections in his/her physical appearance.

Morselli primarily defined dysmorphophobia by the content of the complaint. Following some clinical concepts widespread in continental Europe during the late nineteenth century, he classified the new syndrome among the insanities with fixed ideas, highlighted its obsessional features, and questioned similarities to and differences from other psychiatric disorders. He described the uniform and stable features of dysmorphophobia, but contrasted the contemporary deterministic model of inherited degenerative illness and pointed out the possibility of a favorable outcome.

This chapter investigates the historical and conceptual framework within which the invention of dysmorphophobia happened. Some significant selected passages of Morselli’s writings were translated into English by the authors and are quoted in Italian as well.

In 1987, the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) introduced the expressions delusional disorder somatic type and body dysmorphic disorder (BDD). Dysmorphophobia was officially replaced by the new terms, but the old word did not disappear from the scientific literature.