OBJECTIVE: The authors hypothesized that because patients with body dysmorphic disorder are preoccupied with their appearance and aesthetics, they are more likely to have an occupation or education in art and design than patients with other psychiatric disorders. METHOD: Information on occupation and higher education or training was extracted from the case notes of 100 consecutive patients with body dysmorphic disorder and compared with the same information for 100 patients with a major depressive episode, 100 with obsessive-compulsive disorder (OCD), and 100 with posttraumatic stress disorder (PTSD). RESULTS: Twenty percent of the patients with body dysmorphic disorder had an occupation or education in art or design, compared with 4% of the patients with major depressive episode, 3% of those with OCD, and 0% of those with PTSD. CONCLUSIONS: Onset of body dysmorphic disorder is usually gradual during adolescence, and an education in art and design may be a contributory factor to its development in some patients. An equally plausible explanation is that patients with body dysmorphic disorder tend to have an interest in aesthetics.