1
|
Thomson DR, Thomson NEV, Southwick G. Screening for Body Dysmorphic Disorder in Plastic Surgery Patients. Aesthetic Plast Surg 2024; 48:2738-2743. [PMID: 38538768 DOI: 10.1007/s00266-024-03959-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/16/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION The Australian medical board, the Australian Health Practitioner Regulation Agency (AHPRA) has recently introduced new regulations mandating providers of cosmetic surgery undertake a clinical screen for body dysmorphic disorder (BDD) in all potential cosmetic surgery patients. The assessment must be conducted by the surgeon using a validated psychological screening tool. The aims of this paper are to discuss the key clinical characteristics of BDD before reviewing currently validated screening tools that would meet this new regulatory requirement, and which may be most applicable to a busy plastic surgery practice. METHODS A literature search identified 1164 titles, of which 229 titles were retrieved for abstract screening. Six studies were identified that validated BDD screening tools in a setting relevant to cosmetic plastic surgery. RESULTS Six validated screening were identified: BDD Questionnaire (BDDQ), BDD Questionnaire Dermatology Version (BDDQ-DV), BDD Questionnaire Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), Body Dysmorphia Symptom Scale (BDSS) and the BDD Screening Test (BDD-ST). Our group practice has chosen to adopt the BDDQ-AS to meet the AHPRA regulator requirement for BDD screening based on its robust validation and ease of use in clinical practice, consisting of a seven-item self-report questionnaire that can be reliably completed in 1-2 minutes in most cases. CONCLUSION Of the six screening tools for body dysmorphic disorder available for use in clinical practice that have been validated in a cosmetic population setting, we have chosen to use the BDD Questionnaire Aesthetic Surgery (BDDQ-AS). To date all available validated screening tools are based on the DSM-IV, and further work to develop a validated screening tool based on the revised definition of BDD in the DSM-V is recommended, with a particular focus on items relating to repetitive physical or mental behaviours. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- David R Thomson
- Melbourne Institute of Plastic Surgery, 253 Wattletree Road, Melbourne, Australia.
| | - Natasha E V Thomson
- Hammersmith and Fulham Improving Access to Psychological Therapies (IAPT), West London Mental Health Trust, 194 Hammersmith Road, London, UK
| | - Graeme Southwick
- Melbourne Institute of Plastic Surgery, 253 Wattletree Road, Melbourne, Australia
| |
Collapse
|
2
|
Pereira IN, Chattopadhyay R, Fitzpatrick S, Nguyen S, Hassan H. Evidence-based review: Screening body dysmorphic disorder in aesthetic clinical settings. J Cosmet Dermatol 2023. [PMID: 36847707 DOI: 10.1111/jocd.15685] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/26/2022] [Accepted: 02/02/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a psychiatric disturbance with high incidence in aesthetic clinical settings. Early recognition may avoid unnecessary elective procedures with ethical and medicolegal consequences. AIMS To identify validated BDD screening tools and critically appraise current literature regarding its implementation and efficacy in aesthetic medicine and surgery scenarios, with the purpose of transposing the findings to the broad clinical settings in the field. METHODS Data was collected using advanced search from PubMed (MEDLINE). Having satisfied the search parameters, 12 studies referring BDD definition according to Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria and including a BDD screening tool in clinical aesthetic settings were selected. RESULTS While BDD screening enables the recognition of at-risk individuals, further work is required to uncover the best screening tool for general aesthetic clinical practice. Level III evidence favored BDD Questionnaire (BDDQ)/BDDQ-Dermatology Version (DV), and The Dysmorphic Concern Questionnaire (DCQ) among the limited available validated screening instruments to be used outside the psychiatric environment. Based on level II self-classification, one study selected BDDQ-Aesthetic Surgery (AS) version for rhinoplasty patients. The validation process of both BDDQ-AS and Cosmetic Procedure Screening Questionnaire (COPS) had limitations. For BDD screening potential in avoiding postoperative complications, the limited studies found evaluating the outcomes following aesthetic treatments using validated BDD screening measures showed a trend toward less satisfaction with aesthetic treatment outcome among positive screening population against non-BDD counterparts. CONCLUSION Further research is necessary to establish more effective methods to identify BDD and evaluate the impact of positive findings on aesthetic intervention outcomes. Future studies may elucidate which BDD characteristics best predict a favorable outcome and provide high-quality evidence for standardized protocols in research and clinical practice.
Collapse
Affiliation(s)
| | - Rashmi Chattopadhyay
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Sean Fitzpatrick
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Sheila Nguyen
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Haidar Hassan
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| |
Collapse
|
3
|
Sobouti F, Elyasi F, Navaei RA, Rayatnia F, Kalantari NR, Dadgar S, Rakhshan V. Associations between body dysmorphic disorder (BDD) with the dental health component of the index of orthodontic treatment need (IOTN-DHC) and other BDD risk factors in orthodontic patients: A preliminary study. Korean J Orthod 2023; 53:3-15. [PMID: 36597665 PMCID: PMC9877362 DOI: 10.4041/kjod22.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 01/05/2023] Open
Abstract
Objective Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020-2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results IOTN-DHC scores 1-5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions IOTN-DHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.
Collapse
Affiliation(s)
- Farhad Sobouti
- Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran,Orthodontic Department, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Foruzan Elyasi
- Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farbod Rayatnia
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Sepideh Dadgar
- Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran,Orthodontic Department, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran,Corresponding author: Sepideh Dadgar. Associate Professor, Orthodontic Department, Faculty of Dentistry, Mazandaran University of Medical Sciences, Khazar Blvd, Khazar Square, Sari 4815838594, Iran., Tel +981133244894 e-mail
| | - Vahid Rakhshan
- Department of Dental Anatomy, Dental School, Azad University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Rajabi S, Kamran L, Joukar KamalAbadi M. Epidemiology of body dysmorphic disorder among adolescents: A study of their cognitive functions. Brain Behav 2022; 12:e01710. [PMID: 35307985 PMCID: PMC9015000 DOI: 10.1002/brb3.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 05/02/2020] [Accepted: 05/16/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is characterized by a preoccupation with an imagined defect in one's appearance. In case of a slight physical anomaly, the person would experience an excessive concern. This disorder causes cognitive dysfunction. PURPOSE The aim of this study was to examine epidemiology of body dysmorphic disorder among students at secondary schools of the first and second stage in Shiraz, Iran. It also compares executive functions in students with BDD to healthy students. METHODS The Body Dysmorphic Disorder Questionnaire (BDDQ), Stroop Color and Word Test (SCWT),Wisconsin Card Sorting Test (WCST), Tower of London test (ToL), and Trail Making Test (TMT) were measured in participants with BDD (N = 52; Mage = 16.20; SD = 1.03) and healthy control group (N = 52; Mage = 15.91; SD = 0.96). RESULTS The frequency of BDD was significantly higher in women than men (14.8% vs. 6.8%), and its prevalence was 10.4% in total. There was a significant difference between the two groups of students concerning attentional set-shifting, inhibition of cognitive interference, visual-spatial searching, and sequencing, but not problem-solving tasks. CONCLUSIONS Students with BDD have cognitive deficits, which need to be addressed in cognitive rehabilitation.
Collapse
Affiliation(s)
- Soran Rajabi
- General Psychology, Persian Gulf University, Bushehr, Iran
| | - Leila Kamran
- General Psychology, Persian Gulf University, Bushehr, Iran
| | | |
Collapse
|
5
|
Dons F, Mulier D, Maleux O, Shaheen E, Politis C. Body dysmorphic disorder (BDD) in the orthodontic and orthognathic setting: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e145-e152. [PMID: 34728407 DOI: 10.1016/j.jormas.2021.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
General prevalence of Body Dysmorphic Disorder (BDD), a psychiatric disorder in which patients focus on an imagined body defect not visible to others, varies between 0.7 and 2.5%. Up to 86% present with complaints in the area of teeth or face. Patients with BDD pursue an aesthetic rather than functional recovery, making BDD a possible contraindication to treatment. The aim of this systematic review was to review prevalence of BDD within the orthodontic and/or orthognathic population, to describe diagnostic tools for early detection of patients with BDD and to assess the outcome after treatment. A systematic search was conducted up to November 2020 using PubMed, Embase, Web of Science Core Collection and Cochrane Library. Following the screening of 1423 articles, 5 prospective studies were included. Prevalence of BDD within the orthodontic and orthognathic population varied from 5.2% to 13% (average of 6.2%). Literature showed a trend of higher BDD prevalence within younger, female and single patient population, although results are not conclusive. Questionnaires can be useful for preliminary detection of BDD. General anamnesis with questioning medical or psychiatric history, medication and personal expectations remains very important. Red flags could be previous consultations for the same problem or presence of psychiatric comorbidities. Prospective studies are necessary to map satisfaction of these patients and need for re-interventions after treatment.
Collapse
Affiliation(s)
- Flore Dons
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Delphine Mulier
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Olivia Maleux
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven, Leuven, Belgium
| |
Collapse
|
6
|
Sleep, Distressed Appearance, and Quality of Life Relate to Satisfaction with Orthognathic Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111253. [PMID: 34769770 PMCID: PMC8583211 DOI: 10.3390/ijerph182111253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND In this study, we aimed to identify factors correlating with satisfaction with orthognathic surgery in order to improve its outcome. METHODS We recruited 77 participants who had received orthognathic surgery and 32 age- and gender-matched normal-controls. Questionnaires that included devised questions for family support, Big Five Inventory, Derriford Appearance Score, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, 36-Item Short-Form Health Survey, and a visual analogy scale for satisfaction, were completed before and one month and nine months after the surgery. The statistical analysis methods included descriptive statistics, t-test, and Pearson correlation. RESULTS All participants received the preoperative and one-month follow-up, while 28 also completed the nine-month follow-up. Satisfaction was not significantly related to demographic data, but long-term satisfaction was related to an extraverted personality. The preoperative and postoperative results of the Derriford Appearance Scale were related to short-term and long-term satisfaction. Furthermore, both the preoperative and one-month postoperative Pittsburgh Sleep Quality Index findings were significantly related to short-term satisfaction. The postoperative 36-Item Short-Form Health Survey was significantly related to short-term and long-term satisfaction. CONCLUSIONS Not only subjective distress and dysfunction of appearance but also sleep problems and quality of life were correlated to satisfaction with orthognathic surgery. In the future, relevant interventions can be developed to further improve patient's satisfaction and their physical and mental health.
Collapse
|
7
|
Short-term and Long-term Psychological Impact and Quality of Life of Patients Undergoing Orthognathic Surgery. Biomed J 2021; 45:549-556. [PMID: 34118465 PMCID: PMC9421923 DOI: 10.1016/j.bj.2021.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/25/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Orthognathic Surgery (OGS) is a surgery for patients with dento-facial deformity but not all patients are satisfied with its outcome. The purpose of this study is to find out the short-term and long-term psychological impact and quality-of-life of OGS. Methods 77 participants receiving OGS and 32 age and gender-matched controls were enrolled. The data of questionnaires were collected before OGS, one month and 9 months after OGS, including short form of the Derriford-Appearance-Scale (DAS-24), Big-Five-Inventory (BFI), Hospital-Anxiety-and-Depression-Scale (HADS), Pittsburgh-sleep-quality-index (PSQI), and 36-Item Short-Form-Health-Survey (SF-36). Variables were presented as mean ± standard deviation or frequency. Paired t-test, ANOVA and MANOVA were used to evaluate the pre-and post-surgery data. Results Short-term and long-term satisfaction of OGS was high. Before OGS, BFI showed the extraversion had significant difference between the male and female OGS subgroups. Several domains of DAS-24 were significantly different between the OGS and the control groups. Both groups had no significant difference in PSQI, HADS and SF-36, except sleep-efficiency. After OGS, many domains of DAS-24 were significantly improved and the improvement persisted to 9 months later. Sleep-latency, physical-function, role-limitations-due-to-physical-health and social-functioning exacerbated after OGS. Sleep-latency, physical-function, and social-functioning were improved 9 months after OGS, but sleep-efficiency and role-limitations-due-to-physical-health were still significantly worse than controls. Conclusion People received OGS for unfavorable appearance and the surgery could decrease their distress of appearance and impact to their daily living. Through long-term assessment, we should pay attention to sleep problems and role-limitations-due-to-physical-health after OGS.
Collapse
|
8
|
Casey C, Sharma PK, Ali N, Taylor N, Priestley C, Kingsley M, Royan L. Establishing a clinical psychology team within the orthognathic service: A triad model of orthodontic, maxillofacial and psychological care. J Orthod 2021; 48:190-198. [PMID: 33427022 DOI: 10.1177/1465312520981588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The importance of psychological support for orthognathic patients has taken an increasing precedence over recent years and is embedded in orthognathic commissioning guidelines. Furthermore, attention towards mental health-related conditions and their management is of prime importance and continues to be a key area of focus within healthcare settings. With this in mind, this paper aims to outline our experience of establishing a need for and subsequently securing funding to establish a clinical psychology service within an existing orthognathic service in the NHS. The information outlined may be of benefit to orthognathic teams seeking to secure such psychological support within their respective units.
Collapse
Affiliation(s)
- Christine Casey
- Orthodontic Department, Whipps Cross University Hospital, London, UK.,Centre for Oral Bioengineering, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Sharma
- Centre for Oral Bioengineering, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nayeem Ali
- Department of Oral and Maxillofacial Surgery. Royal London Dental Hospital, London, UK
| | - Nicola Taylor
- Dental Psychology Service, Kings College Dental Institute, London, UK
| | - Charlotte Priestley
- Dental, Oral and Trauma Clinical Psychology Service, Royal London Dental Hospital, London, UK
| | - Marc Kingsley
- Clinical Health Psychology Services, North East London Foundation Trust (NELFT), London, UK
| | - Lindsay Royan
- Clinical Health Psychology Services, North East London Foundation Trust (NELFT), London, UK
| |
Collapse
|
9
|
Body Image Disturbance and Obsessive-Compulsive Disorder Symptoms Improve After Orthognathic Surgery. J Oral Maxillofac Surg 2020; 78:2054-2060. [DOI: 10.1016/j.joms.2020.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 11/30/2022]
|
10
|
Sathyanarayana HP, Padmanabhan S, Balakrishnan R, Chitharanjan AB. Prevalence of Body Dysmorphic Disorder among patients seeking orthodontic treatment. Prog Orthod 2020; 21:20. [PMID: 32743673 PMCID: PMC7396409 DOI: 10.1186/s40510-020-00322-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 05/24/2020] [Indexed: 12/05/2022] Open
Abstract
Background Body Dysmorphic Disorder (BDD) is a psychiatric disorder with delusions about defects in appearance for which patients seek various treatments. Patients with BDD often seek cosmetic procedures, and orthodontic treatment is one among them. This is the first Indian study to determine the prevalence of BDD in an orthodontic outpatient department. Materials and method A total of 1184 patients with varying degrees of malocclusion completed the BDD-YBOCS questionnaire, while an experienced orthodontist assessed the severity of malocclusion with a rating scale. Results Sixty-two patients (5.2%) were screened positive for BDD. Most of the BDD-positive patients were single (p value of 0.02) and had multiple previous consultations for orthodontic treatment (p value of < 0.00**) with a gender predilection toward males (p value of 0.00**), and age was not statistically significant with a p value of 0.3. Conclusion From our study, the prevalence of BDD among orthodontic patients was 5.2%. The orthodontist should be aware of the high prevalence of BDD among orthodontic patients and identify the expectations of the patient at the time of history taking and refer the patient to a psychiatrist for diagnosis and appropriate management.
Collapse
Affiliation(s)
- Haritha Pottipalli Sathyanarayana
- Department of Orthodontics, Sri Ramachandra Dental College, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, 600116, India.
| | - Sridevi Padmanabhan
- Department of Orthodontics, Sri Ramachandra Dental College, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, 600116, India
| | - R Balakrishnan
- Sri Ramachandra Medical Centre, Porur, Chennai, Tamil Nadu, 600116, India
| | | |
Collapse
|
11
|
Mathew P, Mathai PC, David J, Shenoy U, Tiwari R. Current Orthognathic Practice in India: Do We Need to Change? J Maxillofac Oral Surg 2020; 19:1-11. [PMID: 31988555 PMCID: PMC6954926 DOI: 10.1007/s12663-019-01269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The last decade or so has seen paradigm shifts in the various aspects of orthognathic surgery. A lot of these changes are to do with digitalization of the orthodontic-surgical workflow, optimization of surgery-first protocols, virtual surgical planning-based 3D printing solutions and changing patient-health-care dynamics. The aim of this article is to provide evidence-based recommendations that are both practical and economically viable for the current orthognathic practice in India.
Collapse
Affiliation(s)
- Philip Mathew
- Department of Maxillofacial Surgery, Jubilee Mission Medical College, Thrissur, India
| | - Paul C. Mathai
- Department of Maxillofacial Surgery, Jubilee Mission Medical College, Thrissur, India
| | - Jisha David
- Department of Maxillofacial Surgery, Jubilee Mission Medical College, Thrissur, India
| | - Usha Shenoy
- Department of Anesthesiology, Jubilee Mission Medical College, Thrissur, India
| | - Rahul Tiwari
- Department of Maxillofacial Surgery, Jubilee Mission Medical College, Thrissur, India
| |
Collapse
|
12
|
Psychological profiles in patients undergoing orthognathic surgery or rhinoplasty: a preoperative and preliminary comparison. Oral Maxillofac Surg 2019; 23:179-186. [PMID: 31016403 DOI: 10.1007/s10006-019-00758-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to assess, identify, and compare the personality traits and psychosocial status of two groups of patients undergoing orthognathic surgery and rhinoseptoplasty respectively. STUDY DESIGN This prospective study recruited patients referred for orthognathic surgery and for rhinoseptoplasty. The research protocol included the administrations of questionnaires to the patients during their last visit before surgery, including the Minnesota Multiphasic Personality Inventory (MMPI-2), the Myers-Briggs Type Indicator (MBTI), the tree drawing test (or Baum test), and the BC Scale. RESULTS As for MMPI-2, the highest (pathological) percentages were encountered in Hypochondriasis and Psychasthenia scales within the Orthognathic Surgery Group, whereas in the rhinoseptoplasty group, the highest scores were obtained in the Hypochondriasis, Psychasthenia, Psychopathic Deviate, and Schizophrenia scales. CONCLUSIONS It would be important to assess some characteristics of the patients' mental health and emotional state prior to surgery, including depression, anxiety, panic, and aggression. The overview of these factors may give an insight into the psychological and emotional capacity of the patients undergoing orthognathic and rhinoseptoplasty surgery.
Collapse
|
13
|
Abstract
Here, we provide a brief overview of the challenges, innovations and potential opportunities facing contemporary management of individuals requiring orthognathic care.
Collapse
Affiliation(s)
- Farhad B Naini
- Department of Orthodontics, Kingston Hospital and St George’s Hospital NHS Foundation Trust, London, UK
| | - Daljit S Gill
- Department of Orthodontics, Great Ormond Street Hospital NHS Foundation Trust and UCLH Eastman Dental Hospital, London, UK
| |
Collapse
|
14
|
Selvaraj AK, Benington PCM, Murphy L, Ayoub AF. Psychology input to an orthognathic clinic: Patients' perception of service quality. Surgeon 2019; 17:340-345. [PMID: 30661952 DOI: 10.1016/j.surge.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/24/2018] [Accepted: 11/20/2018] [Indexed: 11/17/2022]
Abstract
AIMS The aim of this study was to assess patient satisfaction with a clinical psychology service, integrated within an inter-disciplinary orthognathic planning clinic. METHOD A self-report, custom-designed questionnaire was sent to patients who had completed orthognathic treatment within the last three years. Of the 60 patients approached, 49 responded. RESULTS The great majority of patients agreed that there was a need for a psychological assessment and that its purpose was adequately explained. Most patients were happy with the information given during their appointment and found the experience helpful. A number of patients felt that additional appointments would have been helpful shortly before, and after, surgery. CONCLUSIONS The group of orthognathic patients studied found the pre-treatment psychology assessment, provided for them through the combined clinic, to be very acceptable and beneficial. Some suggested that further appointments, throughout the treatment journey, as well as supportive literature, might also have been helpful.
Collapse
|
15
|
Pérez Rodríguez C, Judge RB, Castle D, Phillipou A. Body dysmorphia in dentistry and prosthodontics: A practice based study. J Dent 2018; 81:33-38. [PMID: 30579858 DOI: 10.1016/j.jdent.2018.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 11/27/2022] Open
Abstract
The prevalence of Body Dysmorphic Disorder (BDD) and dysmorphic concern in dentistry and prosthodontics have not been properly assessed, yet the mouth and the teeth are amongst the top preoccupation for these individuals. OBJECTIVES To evaluate the prevalence of dysmorphic symptoms and BDD using validated tools in patients presenting to general and specialist prosthodontic practice. METHODS Patients were recruited by two prosthodontics practices and three general dentist practices. Patients were given a Dysmorphic Concern Questionnaire (DCQ) integrated into a medical history form. Treating clinicians also completed a Baseline Rating Form assessing the patients´ reason for presentation. Two DCQ score cut-offs were used (9 and 12). RESULTS Two hundred and thirteen patients were recruited, the majority of patients showed DCQ scores below 9 (84%). The prevalence of BDD was 7% (cut-off ≥ 9) or 4% (cut-off ≥12). Women were more likely to present with high DCQ scores as well as people with a history of mental health problems. The cosmetic practice, the implant clinic, and the prosthodontic practice received a higher proportion of patients with high DCQ scores when compared with the general family practice. The type of procedure was not related to DCQ scores. The defect severity assessment and whether this was amenable to correction was moderately correlated with DCQ scores. CONCLUSIONS The DCQ seems to be a suitable tool to be used by dentists as part of history taking and patient examination due to its brevity, simplicity and the good sensitivity/specificity reported in the literature. CLINICAL SIGNIFICANCE Identifying patients with dysmorphia is important before irreversible treatment is carried out due to high levels of dissatisfaction, poor patient centred outcomes and the question of whether these individuals have the capacity to consent.
Collapse
Affiliation(s)
- Carolina Pérez Rodríguez
- Melbourne Dental School, The University of Melbourne, Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia.
| | - Roy B Judge
- Melbourne Dental School, The University of Melbourne, Melbourne, 720 Swanston Street, Carlton, VIC, 3010, Australia.
| | - David Castle
- St Vincent's Hospital and The University of Melbourne, St Vincent´s Mental Health Research Unit. 46 Nicholson St, Fitzroy VIC 3065, Australia.
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Hawthorn VIC 3122, Australia.
| |
Collapse
|
16
|
Li X, Safer DL, Paz IC, Menorca R, Girod S. A Standardized Preoperative Group Intervention Is Feasible and Acceptable to Orthognathic Surgery Patients. J Oral Maxillofac Surg 2017; 76:1546-1552. [PMID: 29245004 DOI: 10.1016/j.joms.2017.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE Nearly 10% of patients remain dissatisfied after orthognathic surgery, largely because of psychoeducational or psychosocial factors. The purpose of this study was to evaluate the feasibility and acceptability of a psychoeducationally based group intervention to improve preoperative preparation of orthognathic surgical patients and their caregivers. MATERIALS AND METHODS The intervention consisted of 2 group sessions, with each session lasting 2 hours. The sessions provided realistic expectations of the surgery, offered teaching strategies for coping with pre- and postoperative symptoms of psychopathology, and highlighted the importance of social support. Feasibility was based on attendance, homework completion, and data collection rates, and acceptability was based on post-treatment participant satisfaction scores on the Client Satisfaction Questionnaire-8 (CSQ-8) and credibility and expectancy scores on 2 subscales of the Credibility/Expectancy Questionnaire-Modified (CEQ-M). RESULTS Twenty-six orthognathic surgical patients were recruited from an outpatient oral and maxillofacial surgery clinic to attend the group-based intervention. Seventy percent of patients who attended at least 1 session completed the 2 sessions, and 64% of those who attended the 2 sessions completed at least 1 homework assignment. The authors successfully collected 84% of the total measures given to patients and their caregivers. The mean satisfaction rating of the patients was 30.12 of 32 (CSQ-8; n = 13; standard deviation [SD], 2.33), the mean credibility rating of the patients and their caregivers was 25.2 of 27 (CEQ-M; n = 20; SD, 1.85), and the mean expectancy rating of the patients and their caregivers was 20.54 of 27 (CEQ-M; n = 20; SD, 4.39). CONCLUSION The psychoeducationally based group intervention was feasible and acceptable for participants and their caregivers. This article offers suggestions to further improve the feasibility and acceptability of the intervention, including optimizing standardization of data collection procedures, decreasing barriers to access, and increasing participant engagement.
Collapse
Affiliation(s)
- Xiaolong Li
- Post-doctoral Fellow, PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA
| | - Debra L Safer
- Faculty, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Imilce Castro Paz
- Medical Student, Department of Surgery, Stanford University School of Medicine, Stanford, CA
| | - Roseanne Menorca
- Research Assistant/Administrator, Department of Surgery, Stanford University School of Medicine, Stanford, CA
| | - Sabine Girod
- Faculty, Department of Surgery, Stanford University School of Medicine, Stanford, CA.
| |
Collapse
|
17
|
Ukra A, Foster Page LA, Thomson WM, Knight RG, Farella M. Self-report of temporomandibular joint clicking and psychological factors: is there an association? J Oral Rehabil 2017; 44:511-516. [PMID: 28386913 DOI: 10.1111/joor.12514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
The objectives of this study were to test the hypothesis that self-reported TMJ clicking sounds in adolescents are positively associated with non-specific somatic symptoms, self-perception of body image and care-seeking behaviour. A cross-sectional study was carried out in 353 young adolescents (48·4% females) recruited from community (N = 272) and orthodontic clinic (N = 81) settings. Assessments included self-reported TMJ clicking, non-specific physical symptoms, body image concerns and for the clinic sample only, the source of motivation for treatment. TMJ sounds were self-reported by 19% of the sample and were associated with higher scores for non-specific physical symptoms and body image concerns (P < 0·001). Adolescents who were self-motivated to seek orthodontic treatment had greater scores for non-specific physical symptoms, more body image concerns and tended to report TMJ sounds more often (26·3% and 7·7% respectively; P = 0·41) than those who were solely parent/family-motivated to seek treatment. Self-reported TMJ sounds in adolescents were associated with a propensity to somatisation and concerns with body image. Care-seeking adolescents have greater non-specific physical symptoms and body image concerns and tend to report more frequent TMJ sounds.
Collapse
Affiliation(s)
- A Ukra
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - L A Foster Page
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - W M Thomson
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - R G Knight
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - M Farella
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
18
|
Bowyer L, Krebs G, Mataix-Cols D, Veale D, Monzani B. A critical review of cosmetic treatment outcomes in body dysmorphic disorder. Body Image 2016; 19:1-8. [PMID: 27517118 DOI: 10.1016/j.bodyim.2016.07.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 07/14/2016] [Indexed: 11/18/2022]
Abstract
A high proportion of individuals with body dysmorphic disorder (BDD) undergo cosmetic treatments in an attempt to 'fix' perceived defect/s in their physical appearance. Despite the frequency with which such procedures are sought, few studies have prospectively examined the outcomes of cosmetic procedures in individuals with BDD. This article aims to critically review the literature and discuss the current debate that exists on outcomes of cosmetic treatment for individuals with BDD. An emerging literature suggests the majority of individuals with BDD have poor outcomes after cosmetic interventions; however, based on the current literature, it cannot be fully ruled out that certain individuals with mild BDD and localised appearance concerns may benefit from these interventions. Gaps in the current literature are highlighted, alongside recommendations for future research. Carefully conducted longitudinal studies with well-characterised patient populations are needed.
Collapse
Affiliation(s)
- Laura Bowyer
- National and Specialist OCD, BDD and Related Disorders Clinic, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
| | - Georgina Krebs
- National and Specialist OCD, BDD and Related Disorders Clinic, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; King's College London, Social, Genetic and Development Centre, Institute of Psychiatry, Psychology and Neurosciences, London SE5 8AF, UK
| | - David Mataix-Cols
- Child and Adolescent Psychiatry Research Centre, Karolinska Institutet, Stockholm, Sweden
| | - David Veale
- Centre for Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; King's College London, Institute of Psychiatry, Psychology & Neurosciences, London SE5 8AF, UK
| | - Benedetta Monzani
- King's College London, Institute of Psychiatry, Psychology & Neurosciences, London SE5 8AF, UK
| |
Collapse
|
19
|
Christensen L, Luther F. Adults seeking orthodontic treatment: expectations, periodontal and TMD issues. Br Dent J 2016; 218:111-7. [PMID: 25686427 DOI: 10.1038/sj.bdj.2015.46] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 01/06/2023]
Abstract
The growth in adult orthodontics presents new challenges to both the general dental practitioner and the orthodontist. Although many of the main objectives of orthodontic treatment are similar for adults, young adults and children, adult patients frequently bring significant challenges in several areas not often seen in the younger patient group. In areas such as planning realistic treatment outcomes, it is paramount that the patient's expectations are identified, respected and managed where appropriate. The adult patient's dental health often dictates deviation from the ideal treatment plan and periodontal problems are a common example. Based on current evidence, this paper presents an overview of some of the difficulties in the management of these issues, as well as highlighting developments with regard to pain conditions and their relevance to orthodontic treatment and its effects on temporomandibular joint disorders (TMD) management.
Collapse
Affiliation(s)
- L Christensen
- Specialist in Orthodontics, 69-71 Banbury Road, Oxford, OX2 6PE
| | - F Luther
- Consultant and Honorary Senior Clinical Lecturer in Orthodontics, Charles Clifford Dental Hospital (Sheffield Teaching Hospitals NHS Foundation Trust), 76 Wellesley Road, Sheffield, S10 2SZ
| |
Collapse
|
20
|
Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image 2016; 18:168-86. [PMID: 27498379 DOI: 10.1016/j.bodyim.2016.07.003] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 06/30/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022]
Abstract
Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified.
Collapse
|
21
|
Reduced striatal dopamine D2/3 receptor availability in Body Dysmorphic Disorder. Eur Neuropsychopharmacol 2016; 26:350-356. [PMID: 26711686 DOI: 10.1016/j.euroneuro.2015.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/20/2015] [Accepted: 11/23/2015] [Indexed: 11/23/2022]
Abstract
Though the dopaminergic system is implicated in Obsessive Compulsive and Related Disorders (OCRD), the dopaminergic system has never been investigated in-vivo in Body Dysmorphic Disorder (BDD). In line with consistent findings of reduced striatal dopamine D2/3 receptor availability in Obsessive Compulsive Disorder (OCD), we hypothesized that the dopamine D2/3 receptor availability in the striatum will be lower in patients with BDD in comparison to healthy subjects. Striatal dopamine D2/3 receptor Binding Potential (BPND) was examined in 12 drug-free BDD patients and 12 control subjects pairwise matched by age, sex, and handedness using [(123)I]iodobenzamide Single Photon Emission Computed Tomography (SPECT; bolus/constant infusion technique). Regions of interest were the caudate nucleus and the putamen. BPND was calculated as the ratio of specific striatal to binding in the occipital cortex (representing nonspecific binding). Compared to controls, dopamine D2/3 receptor BPND was significantly lower in BDD, both in the putamen (p=0.017) and caudate nucleus (p=0.022). This study provides the first evidence of a disturbed dopaminergic system in BDD patients. Although previously BDD was classified as a separate disorder (somatoform disorder), our findings give pathophysiological support for the recent reclassification of BDD to the OCRD in DSM-5.
Collapse
|
22
|
Takatsuji H, Kobayashi T, Kojima T, Hasebe D, Izumi N, Saito I, Saito C. Effects of orthognathic surgery on psychological status of patients with jaw deformities. Int J Oral Maxillofac Surg 2015; 44:1125-30. [DOI: 10.1016/j.ijom.2015.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 12/11/2014] [Accepted: 02/03/2015] [Indexed: 10/23/2022]
|
23
|
Liddle MJ, Baker SR, Smith KG, Thompson AR. Psychosocial Outcomes in Orthognathic Surgery: A Review of the Literature. Cleft Palate Craniofac J 2015; 52:458-70. [DOI: 10.1597/14-021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To identify and critically appraise the literature on the psychosocial outcomes of orthognathic surgery, reflect on the clinical and theoretical implications, and suggest avenues for future research. Design A search of the literature was completed using the databases Web of Science, MEDLINE, and PsycINFO to identify English-language articles published since January 2001 that have reported a measure of psychosocial functioning posttreatment. Results A total of 38 articles were eligible for inclusion in the review. The studies reported improvements in areas such as satisfaction with facial appearance, self-confidence, self-esteem, anxiety, and social functioning. Small percentages of patients were left dissatisfied or had difficulty adjusting to appearance change despite the absence of treatment complications. Gains in psychosocial functioning were maintained over several years, and satisfaction increased over time. Conclusions There are consistent positive outcomes reported as a result of orthognathic surgery, but conclusions are limited by methodological issues in study design such as small sample sizes, limited use of control groups, and measures that fail to tap into relevant areas of psychosocial functioning. In addition, further exploration is required of processes such as adjustment to facial change and the role of psychological support during treatment.
Collapse
Affiliation(s)
- Morna J. Liddle
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Sarah R. Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Keith G. Smith
- Oral and Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Andrew R. Thompson
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| |
Collapse
|
24
|
Woolley AJ, Perry JD. Body dysmorphic disorder: prevalence and outcomes in an oculofacial plastic surgery practice. Am J Ophthalmol 2015; 159:1058-1064.e1. [PMID: 25728858 DOI: 10.1016/j.ajo.2015.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/19/2015] [Accepted: 02/24/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the prevalence, associated factors, and surgical outcomes of patients with body dysmorphic disorder in an oculofacial surgery practice. DESIGN Retrospective cross-sectional analysis of a consecutive case series. METHODS Participants consisted of a consecutive series of 728 patients who completed the Dysmorphic Concern Questionnaire in an oculofacial surgery practice at The Cole Eye Institute between November 2013 and June 2014. A questionnaire score ≥9 was used as a positive screen for body dysmorphic disorder. Three control patients scoring ≤8 in the same month were randomly selected for each positive-screening patient. Main outcome measures included number of reoperations, surgical complications, and follow-up visits; preoperative and postoperative pain scores; and the technician word count. Categorical variables were analyzed with Pearson χ(2) tests or Fisher exact tests, while continuous variables were analyzed with Wilcoxon rank sum tests or t tests. RESULTS A total of 728 patients completed the questionnaire and 50 (6.9%) scored 9 or more. Using a confidence interval of 95%, patients in the positive questionnaire screen group were younger (P = .004), had more eyelid surgeries (P = .007), experienced higher rates of complications after surgery (P = .002), reported higher postoperative pain scores (P = .034), required more reoperations (P = .050), and had a higher technician word count compared to the control group (P = .003). CONCLUSIONS The prevalence of body dysmorphic disorder in an oculofacial surgical setting matches reports from other surgical specialties, and is significantly higher than in the general population. Patients screening positively for body dysmorphic disorder tend to have higher postoperative pain scores and more postoperative complications.
Collapse
Affiliation(s)
- Austin J Woolley
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Julian D Perry
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
| |
Collapse
|
25
|
|
26
|
Hammond D, Williams RW, Juj K, O'Connell S, Isherwood G, Hammond N. Weight loss in orthognathic surgery: a clinical study. J Orthod 2015; 42:220-8. [PMID: 25904194 DOI: 10.1179/1465313314y.0000000130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To analyse weight change, body composition change and Body Mass Index change in patients undergoing orthognathic surgery. DESIGN A service evaluation was undertaken in orthognathic patients pre-operatively and at 4 weeks post-surgery. SETTING Queen Elizabeth Hospital Birmingham outpatient department. SUBJECTS Thirty-one patients scheduled for single- or two-jaw orthognathic surgery and rigid internal fixation. METHODS Immediately pre-operatively and at 4 weeks post-surgery the following information was gathered: (1) patient height; (2) patient weight (kg); (3) Patient Body Mass Index; and (4) patient body fat percentage. RESULTS In the 4-week post-operative period, the average weight loss was -4·96 kg (range: -9·6 to +3·0 kg), with a body fat reduction of -3·07% (range: -5·80% to +2·30%) and an average reduction in Body Mass Index of -1·63 (range: -3·4 to +0·8). There was no statistically significant difference in weight loss (P = 0·1562) or body fat composition change (P = 0·2391) between single- or two-jaw surgery. There was no statistically significant difference in weight loss (P = 0·4858) or body fat composition change (P = 0·5321) between male and female patients. CONCLUSIONS Weight loss observed was similar to that reported in studies using inter-maxillary fixation. Closer psychological and dietetic support is needed for patients who have a low normal or underweight Body Mass Index. Better and more bespoke tailored Oral Nutritional Supplementation must be provided for all orthognathic surgery patients to potentially reduce this significant weight loss.
Collapse
|
27
|
Newton JT, Cunningham SJ. Great expectations: What do patients expect and how can expectations be managed? J Orthod 2014; 40:112-7. [DOI: 10.1179/1465313312y.0000000038] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
28
|
Collins B, Gonzalez D, Gaudilliere DK, Shrestha P, Girod S. Body dysmorphic disorder and psychological distress in orthognathic surgery patients. J Oral Maxillofac Surg 2014; 72:1553-8. [PMID: 24582136 DOI: 10.1016/j.joms.2014.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Body dysmorphic disorder (BDD) is a distressing condition involving preoccupation with an imagined or exaggerated deformity. The purpose of our study was to investigate the presence of BDD and its comorbidity with anxiety, depression, and obsessive-compulsive disorder (OCD) in patients undergoing orthognathic surgery (OS). MATERIALS AND METHODS The present prospective study included 99 patients from the outpatient oral and maxillofacial surgery clinic at Stanford University who requested OS. The incidence of BDD, depression, anxiety, and OCD was assessed preoperatively using validated self-report measures. To determine the prevalence of Axis I psychological symptoms among patients, the descriptive and bivariate statistics were computed. P < .05 was considered significant. RESULTS In our sample, 13 patients (13%) screened positive for BDD. We did not find any significant correlations between the presence of BDD and gender, race, age, or marital status. Depressive symptoms were reported by 42% of the patients, OCD symptoms by 29%, and mild, moderate, and severe anxiety by 14%, 5%, and 4%, respectively. Using Spearman correlations, we found significant correlations between BDD and anxiety, depression, and OCD (P < .01). CONCLUSIONS The results of the present study suggest that the rates of BDD, depression, anxiety, and OCD are high in patients undergoing OS. Furthermore, we found a strong correlation between BDD and anxiety, OCD, and depression in these patients. Future studies are necessary to determine the postoperative changes in these psychological disorders and whether these changes are affected by having positive BDD screening results at baseline.
Collapse
Affiliation(s)
| | - Daisy Gonzalez
- Undergraduate Student, Stanford University, Stanford, CA
| | - Dyani Kalea Gaudilliere
- Clinician Instructor, Oral Medicine and Maxillofacial Surgery, Stanford University School of Medicine, Stanford, CA
| | - Puja Shrestha
- Visiting Scientist, Oral Medicine and Maxillofacial Surgery, Stanford University School of Medicine, Stanford, CA
| | - Sabine Girod
- Chief, Oral Medicine and Maxillofacial Surgery, Stanford University School of Medicine, Stanford, CA.
| |
Collapse
|
29
|
Brohede S, Wingren G, Wijma B, Wijma K. Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women. Psychiatry Res 2013; 210:647-52. [PMID: 23948660 DOI: 10.1016/j.psychres.2013.07.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 05/29/2013] [Accepted: 07/10/2013] [Indexed: 11/18/2022]
Abstract
Body Dysmorphic Disorder (BDD) is characterized by a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients with the disorder present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in the general population and have shown that the disorder is relatively common. To date, no BDD assessment instruments have been validated in the general population. Our aim was to validate a brief self-screening instrument, the Body Dysmorphic Disorder Questionnaire (BDDQ), in a female community sample. The BDDQ was translated into Swedish and filled out by 2891 women from a randomly selected community sample. The questionnaire was validated in a subsample of 88 women, using the Structured Clinical Interview for DSM-IV (SCID) together with clinical assessment as the gold standard. In the validation subsample, the BDDQ showed good concurrent validity, with a sensitivity of 94%, a specificity of 90% and a likelihood ratio of 9.4. The questionnaire can therefore be of value when screening for BDD in female populations.
Collapse
Affiliation(s)
- Sabina Brohede
- Unit of Medical Psychology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, S-581 83 Linköping, Sweden.
| | | | | | | |
Collapse
|
30
|
Mufaddel A, Osman OT, Almugaddam F, Jafferany M. A review of body dysmorphic disorder and its presentation in different clinical settings. Prim Care Companion CNS Disord 2013; 15:12r01464. [PMID: 24392251 DOI: 10.4088/pcc.12r01464] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/22/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Body dysmorphic disorder (BDD) is a relatively common psychiatric disorder characterized by preoccupations with perceived defects in physical appearance. This review aimed to explore epidemiology, clinical features, comorbidities, and treatment options for BDD in different clinical settings. DATA SOURCE AND STUDY SELECTION A search of the literature from 1970 to 2011 was performed using the MEDLINE search engine. English-language articles, with no restriction regarding the type of articles, were identified using the search terms body dysmorphic disorder, body dysmorphic disorder clinical settings, body dysmorphic disorder treatment, and body dysmorphic disorder & psychodermatology. RESULTS BDD occurs in 0.7% to 2.4% of community samples and 13% of psychiatric inpatients. Etiology is multifactorial, with recent findings indicating deficits in visual information processing. There is considerable overlap between BDD and obsessive-compulsive disorder (OCD) in symptom etiology and response to treatment, which has led to suggestions that BDD can be classified with anxiety disorders and OCD. A recent finding indicated genetic overlap between BDD and OCD. Over 60% of patients with BDD had a lifetime anxiety disorder, and 38% had social phobia, which tends to predate the onset of BDD. Studies reported a high level of comorbidity with depression and social phobia occurring in > 70% of patients with BDD. Individuals with BDD present frequently to dermatologists (about 9%-14% of dermatologic patients have BDD). BDD co-occurs with pathological skin picking in 26%-45% of cases. BDD currently has 2 variants: delusional and nondelusional, and both variants respond similarly to serotonin reuptake inhibitors (SRIs), which may have effect on obsessive thoughts and rituals. Cognitive-behavioral therapy has the best established treatment results. CONCLUSIONS A considerable overlap exists between BDD and other psychiatric disorders such as OCD, anxiety, and delusional disorder, and this comorbidity should be considered in evaluation, management, and long-term follow-up of the disorder. Individuals with BDD usually consult dermatologists and cosmetic surgeons rather than psychiatrists. Collaboration between different specialties (such as primary care, dermatology, cosmetic surgery, and psychiatry) is required for better treatment outcome.
Collapse
Affiliation(s)
- Amir Mufaddel
- Behavioral Sciences Institute, Alain Hospital, Al Ain, United Arab Emirates (Dr Mufaddel); Department of Psychiatry and Behavioral Sciences, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates (Dr Osman); Department of Psychiatry and Behavioral Science, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (Ms Almugaddam); and Department of Psychiatry and Behavioral Sciences, Central Michigan University, College of Medicine, and Jafferany Psychiatric Services (Dr Jafferany), Saginaw, Michigan
| | - Ossama T Osman
- Behavioral Sciences Institute, Alain Hospital, Al Ain, United Arab Emirates (Dr Mufaddel); Department of Psychiatry and Behavioral Sciences, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates (Dr Osman); Department of Psychiatry and Behavioral Science, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (Ms Almugaddam); and Department of Psychiatry and Behavioral Sciences, Central Michigan University, College of Medicine, and Jafferany Psychiatric Services (Dr Jafferany), Saginaw, Michigan
| | - Fadwa Almugaddam
- Behavioral Sciences Institute, Alain Hospital, Al Ain, United Arab Emirates (Dr Mufaddel); Department of Psychiatry and Behavioral Sciences, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates (Dr Osman); Department of Psychiatry and Behavioral Science, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (Ms Almugaddam); and Department of Psychiatry and Behavioral Sciences, Central Michigan University, College of Medicine, and Jafferany Psychiatric Services (Dr Jafferany), Saginaw, Michigan
| | - Mohammad Jafferany
- Behavioral Sciences Institute, Alain Hospital, Al Ain, United Arab Emirates (Dr Mufaddel); Department of Psychiatry and Behavioral Sciences, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates (Dr Osman); Department of Psychiatry and Behavioral Science, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (Ms Almugaddam); and Department of Psychiatry and Behavioral Sciences, Central Michigan University, College of Medicine, and Jafferany Psychiatric Services (Dr Jafferany), Saginaw, Michigan
| |
Collapse
|
31
|
Picavet V, Gabriëls L, Jorissen M, Hellings PW. Screening tools for body dysmorphic disorder in a cosmetic surgery setting. Laryngoscope 2011; 121:2535-41. [DOI: 10.1002/lary.21728] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
32
|
Kovalenko A, Slabkovskaya A, Drobysheva N, Persin L, Drobyshev A, Maddalone M. The association between the psychological status and the severity of facial deformity in orthognathic patients. Angle Orthod 2011; 82:396-402. [PMID: 22007634 DOI: 10.2319/060211-363.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the psychological status and correlate it with the severity of facial deformities of patients with skeletal malocclusions before orthognathic treatment. MATERIALS AND METHODS A total of 96 patients aged 15 to 47 with skeletal malocclusions were examined before orthognathic treatment was provided. A photographic analysis was carried out to determine the severity of facial deformity according to the Facial Aesthetic Index (FA1). All patients were divided into three groups according to the FAI score: light (0 to 9), moderate (10 to 19), and severe (>19) facial deformities. Thirty subjects aged 17 to 39 with normal occlusion and attractive harmonious faces without previous orthodontic and/or surgical history were taken as controls. Psychological testing of controls and patients in the study group was performed before orthognathic treatment was provided. RESULTS Psychological testing showed no statistically significant differences among groups with light and moderate facial deformity and subjects in the control group. Significant differences were encountered among patients with severe facial deformities compared with controls in a series of personality traits, including introversion, neuroticism, trait anxiety, dependency, unsociability, and leadership. CONCLUSIONS Orthognathic patients with different degrees of facial deformity have different psychological profiles. Patients with light and moderate facial deformity have no significant psychological problems. Patients with severe facial deformity show a significantly higher prevalence of emotional instability, introversion, anxiety, and unsociability. Such psychological profiles make orthognathic patients with severe facial deformity prone to psychological distress, depression, and adverse psychological reactions.
Collapse
Affiliation(s)
- Aleksandra Kovalenko
- Department of Orthodontics, Moscow State University of Medicine and Dentistry, Moscow, Russia.
| | | | | | | | | | | |
Collapse
|
33
|
Tignol J, Martin-Guehl C, Aouizerzate B. [Body dysmorphic disorder (BDD)]. Presse Med 2011; 41:e22-35. [PMID: 21831574 DOI: 10.1016/j.lpm.2011.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 05/22/2011] [Accepted: 05/30/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Body Dysmorphic Disorder (BDD) has replaced the old and ill-defined concept of dysmorphophobia since its introduction as a full-blown disorder in DSM-III-R in 1987. Since then, the body of knowledge on BDD has considerably increased. At the same time, cosmetic medicine and surgical procedures, for which the indications and outcomes of BDD should be taken into account, have become common. Hence, we decided to undertake a review of the literature on BDD aimed at French speaking practitioners. METHOD We searched Medline for the literature on BDD and dysmorphophobia in English and in French and made a critical examination of findings resulting from those studies where the methodology was sound. RESULTS BDD is frequent in the general population with a point prevalence between 1.7 and 2.4% and often severe. Delusive and non-delusive forms of BDD likely belong to the same entity and both respond to the same treatment. Serotonin reuptake inhibitors and cognitive behavioral therapies have demonstrated their efficacy in randomized controlled studies. Esthetic, medical and surgical treatments, which are very often sought after by BDD patients, have been shown to be ineffective and potentially harmful. DISCUSSION Our review confirms the progress in knowledge on BDD. The most interesting results concern clinical characteristics, epidemiology in the general population, and treatment. The prevalence of BDD in the general population should prompt every practitioner to take this disorder into account when faced with the increasing demand for medical and surgical cosmetic procedures. Nevertheless, further research is needed, particularly on the demand of non psychiatric treatments by BDD patients and the way medical or surgical specialists manage it.
Collapse
Affiliation(s)
- Jean Tignol
- Faculté de médecine de l'université de Bordeaux, 33000 Bordeaux, France.
| | | | | |
Collapse
|
34
|
Cadogan J, Bennun I. Face value: an exploration of the psychological impact of orthognathic surgery. Br J Oral Maxillofac Surg 2011; 49:376-80. [DOI: 10.1016/j.bjoms.2010.07.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 07/09/2010] [Indexed: 10/19/2022]
|
35
|
Lai CS, Lee SS, Yeh YC, Chen CS. Body dysmorphic disorder in patients with cosmetic surgery. Kaohsiung J Med Sci 2011; 26:478-82. [PMID: 20837344 DOI: 10.1016/s1607-551x(10)70075-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 04/16/2010] [Indexed: 10/19/2022] Open
Abstract
Body dysmorphic disorder (BDD) refers to a preoccupation with an imagined or grossly exaggerated minor physical defect. Those with BDD might seek medical help (cosmetic surgery) rather than attend a psychiatric clinic. Therefore, it is often underdiagnosed. To investigate the prevalence of BDD, we reviewed the medical records of 817 individuals who sought cosmetic surgery during a 3-year period. The outcome after surgery was described for those with BDD. Our results showed that 63 (7.7%) patients had BDD, of which 54 (85.7%) were diagnosed at preoperative evaluation. However, nine (14.3%) patients went undiagnosed and all had a bad outcome after cosmetic surgery. BDD was not uncommon at the cosmetic surgery clinic. Our results support the idea that cosmetic surgery should be avoided for patients with BDD. The development of a more effective diagnostic procedure could help address this issue.
Collapse
Affiliation(s)
- Chung-Sheng Lai
- Department of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | | | | |
Collapse
|
36
|
Sarwer DB, Crerand CE, Magee L. Body dysmorphic disorder in patients who seek appearance-enhancing medical treatments. Oral Maxillofac Surg Clin North Am 2011; 22:445-53. [PMID: 20970710 DOI: 10.1016/j.coms.2010.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most patients who seek appearance-enhancing medical treatments report some degree of body image dissatisfaction, which is believed to motivate the pursuit of these treatments. However, patients with extreme body image dissatisfaction may be suffering from a psychiatric disorder known as body dysmorphic disorder (BDD). This article reviews BDD, including its clinical features and prevalence in medical settings. Although patients with BDD frequently seek cosmetic treatments to address their appearance-related distress, such treatments are rarely beneficial. The article concludes with recommendations for patient and provider safety.
Collapse
Affiliation(s)
- David B Sarwer
- Division of Plastic Surgery, Department of Surgery, The Edwin and Fannie Gray Hall Center for Human Appearance, The University of Pennsylvania School of Medicine, 10 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | | | | |
Collapse
|
37
|
Perception of improvement after orthognathic surgery: the important variables affecting patient satisfaction. Oral Maxillofac Surg 2010; 14:155-62. [PMID: 20306101 PMCID: PMC2928919 DOI: 10.1007/s10006-010-0212-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Purpose We evaluated which factors affect patient satisfaction and if patient expectations were fulfilled after orthognathic surgery. Methods Questionnaires consisting of 14 questions were given 1 year after bimaxillary osteotomy for class-III correction to subjects. Six questions were answered using an 11-point rating scale based on a visual analog scale (VAS; 0 = poor; 10 = excellent). Also included were seven closed-form questions with yes/no answers, as well as one open question for ‘further remarks’. Sagittal and vertical cephalometric parameters were determined on postoperative cephalograms. Results Seventy-seven patients (37 females, 40 males; mean age, 23.4 ± 4.9 (SD) years) responded. The intention to undergo surgery only for aesthetic improvement was noted in 11.9% of patients; only improvement of chewing function in 15.5%; both in 71.4%; and none/don't know in 2.6%. Postoperative satisfaction was rated (in means) with 8.13 ± 1.97 on VAS and correlated significantly with the opinions of friends and relatives. Facial aesthetics was rated 5.6 ± 1.2 before surgery and 8.1 ± 1.5 after surgery (p = 0.04). Preoperative chewing function was rated 5.65 ± 1.8 and 8.03 ± 1.51 after surgery (p = 0.014). TMJ disorders or hypoesthesia had no negative impacts. Cephalometric analyses revealed a significantly lower SNB (75.3° ± 2.7°; p = 0.033) in patients rating lower than grade 7 for overall satisfaction. For SNA and ArGoMe, no significant differences were observed. Conclusion The most distinctive factors for patient satisfaction after orthognathic surgery were chewing function and facial aesthetics with respect to the lower face. Function, aesthetics, and even psychological aspects should be considered equally when planning surgery.
Collapse
|
38
|
Øland J, Jensen J, Melsen B, Elklit A. Are Personality Patterns and Clinical Syndromes Associated With Patients' Motives and Perceived Outcome of Orthognathic Surgery? J Oral Maxillofac Surg 2010; 68:3007-14. [DOI: 10.1016/j.joms.2010.07.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 07/22/2010] [Accepted: 07/29/2010] [Indexed: 11/26/2022]
|
39
|
Gilmartin J. Contemporary cosmetic surgery: the potential risks and relevance for practice. J Clin Nurs 2010; 20:1801-9. [DOI: 10.1111/j.1365-2702.2010.03527.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Alanko OME, Svedström-Oristo AL, Tuomisto MT. Patients' perceptions of orthognathic treatment, well-being, and psychological or psychiatric status: a systematic review. Acta Odontol Scand 2010; 68:249-60. [PMID: 20513168 DOI: 10.3109/00016357.2010.494618] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To conduct a systematic review of studies concerning the psychosocial well-being of surgical-orthodontic patients. MATERIAL AND METHODS Articles published between 2001 and 2009 were searched using PubMed, Web of Science, and PsycInfo. Only articles written in English were included. Articles on methodological issues or on patients with clefts or syndromes or studies in which treatment had included surgically assisted maxillary expansion or intermaxillary fixation were excluded. The exclusion of articles was carried out in collaboration with two reviewers. To find new relevant articles, references from all the obtained review articles were hand-searched. Thirty-five articles fulfilled the selection criteria and were included in this review. RESULTS The main motives for seeking treatment were improvements in self-confidence, appearance, and oral function. Patients were not found to suffer from psychiatric problems. Treatment resulted in self-reported improvements in well-being, even though these improvements were not found with current assessment methods. Changes in well-being were most often registered using measures designed for evaluation of the impact of oral health on quality of life (e.g. the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile). CONCLUSIONS Surgical-orthodontic patients do not experience psychiatric problems related to their dentofacial disharmony in general. However, subgroups of patients may still experience problems, such as anxiety or depression, as many studies only report patients' mean problem scores and compare them to controls' scores or population norms. New assessment methods focusing on day-to-day changes in mood and well-being, as well as prospective studies with controls, are needed.
Collapse
Affiliation(s)
- Outi M E Alanko
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Finland
| | | | | |
Collapse
|
41
|
|
42
|
Körperdysmorphe Störung. PSYCHOTHERAPEUT 2010. [DOI: 10.1007/s00278-009-0719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|