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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 .
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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
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Mandavia R, D'Souza H, Rupasinghe T, Cariati M, Mandavia T. An Evidence-based Pathway for Body Dysmorphic Disorder in Facial Aesthetics. Facial Plast Surg 2024. [PMID: 38216141 DOI: 10.1055/a-2244-1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
Aesthetic procedures should be avoided in patients with body dysmorphic disorder (BDD) since they can negatively impact mental health and lead to further aesthetic dissatisfaction. There are no evidence-based patient pathways for BDD in facial aesthetics which can result in the failure to identify patients with BDD, leading to unsuitable treatments and suboptimal patient care. We aim to construct the first evidence-based patient pathway for BDD in surgical and nonsurgical facial aesthetics. A systematic review was performed and articles that discussed screening or patient pathways for BDD in field of facial aesthetics were included. We extracted relevant information from each article on screening tools and pathways for BDD. Data were synthesized by summarizing the data under column headings into a structured narrative and into new tables. Based on this synthesis, a practical pathway for BDD was constructed. Forty articles fulfilled the criteria for inclusion. Twenty-eight BDD screening tools were discussed in the included articles, and we provide an overview of these tools. Thirty-one articles discussed patient pathways for BDD, and we synthesized this information into a structured narrative. Combining these findings, we present an evidence-based patient pathway for BDD for patients presenting for facial aesthetic treatments. This systematic review has resulted in the first, evidence-based, patient pathway for BDD in surgical and nonsurgical facial aesthetics. This practical pathway can be used by aesthetic clinicians to identify patients with potential BDD and provide clear guidance for managing cases where BDD is suspected. It will help reduce the number of facial aesthetic procedures performed on patients with BDD, safeguard patient mental well-being, and prevent further aesthetic dissatisfaction.
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Affiliation(s)
- Rishi Mandavia
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
| | - Hanna D'Souza
- King's College London, School of Medicine, London, United Kingdom
| | - Thiara Rupasinghe
- University College London, School of Medicine, London, United Kingdom
| | - Massimiliano Cariati
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
| | - Tatiana Mandavia
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
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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.
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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
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Mascarenhas JG, de Deus MM, Kosugi EM, de C. Guimarães V. Prevalence of Body Dysmorphic Disorder and Dysmorphic Symptoms in Rhinoplasty Candidates: a Systematic Review and Meta-Analysis. TRENDS IN PSYCHOLOGY 2022. [DOI: 10.1007/s43076-022-00237-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lekakis G, Constantian M, Most SP, Picavet V, Hellings PW. Novel Selection Tools in Rhinoplasty Patients. Facial Plast Surg 2022; 38:447-454. [PMID: 36100246 DOI: 10.1055/s-0042-1748314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
With no consensus document or guideline to help us compute the psychological make-up of rhinoplasty candidates and in the light of new perspectives of some key opinion leaders in the field of patient selection, the goals of this article are to offer a glimpse of the current literature together with the knowledge gaps, introduce some new tools for the preoperative consultation, help us identify who among our patients is at greatest risk for a poor outcome, and explain how childhood trauma can be linked to body shame and postoperative dissatisfaction.
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Affiliation(s)
- Garyfalia Lekakis
- Department of Otorhinolaryngology Head and Neck Surgery, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium.,Department of Otorhinolaryngology Head and Neck Surgery, Hopital Moliere Longchamp, Brussel, Brussel, Belgium
| | - Mark Constantian
- Department of Surgery, University of Wisconsin-Madison Center for Health Systems Research and Analysis, Hollis, New Hampshire.,Department of Plastic Surgery, University of Virginia, Charlottesville, Virginia
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California
| | - Valerie Picavet
- Department of ENT, ENT Practice Moser Gehrking Sauter and Partner, Augsburg, Germany
| | - Peter William Hellings
- Department of Otorhinolaryngology Head and Neck Surgery, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
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Salari N, Kazeminia M, Heydari M, Darvishi N, Ghasemi H, Shohaimi S, Mohammadi M. Body dysmorphic disorder in individuals requesting cosmetic surgery: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2022; 75:2325-2336. [PMID: 35715310 DOI: 10.1016/j.bjps.2022.04.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/14/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is known as a mental disorder in which a person suffers from concern and distress with the perceived defects in their appearance and subsequently can experience significant impairment in social, occupational, and interpersonal functioning. Various studies have reported different BDD prevalence rates in patients with cosmetic surgery. However, there has been no comprehensive study that has examined the results of these studies. Therefore, this study aims to determine BDD prevalence in individuals requesting cosmetic surgery in a systematic review and meta-analysis. METHODS In this review study, a search was conducted in national and international databases of Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) between 1878 and January 2020. A random-effects model was used to analyze the data, and heterogeneity of studies was examined with the I2 index. Data analysis was done using comprehensive meta-analysis (Version 2). RESULTS BDD prevalence in individuals requesting cosmetic surgery in 48 articles with a sample size of 14,913 was 19.2% (95% CI: 15.8-23%). Regarding heterogeneity based on meta-regression, a significant difference between the sample size (p<0.001) and BDD prevalence in patients with cosmetic surgery was observed. CONCLUSION The results of this study showed that BDD prevalence in individuals requesting cosmetic surgery is high. Therefore, with the provision of feedback at hospitals, appropriate interventions, such as pre-screening for body image disturbance, should be mandated.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee of Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammadbagher Heydari
- Department of General Surgery, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Darvishi
- Student Research Committee of Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hooman Ghasemi
- Student Research Committee of Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Alghamdi WA, Subki AH, Khatib HA, Butt NS, Alghamdi RA, Alsallum MS, Alharbi AA, Almatrafi MN, Alobisi AA, Al-Zaben F, Koenig HG. Body Dysmorphic Disorder Symptoms: Prevalence and Risk Factors in an Arab Middle Eastern Population. Int J Gen Med 2022; 15:2905-2912. [PMID: 35300125 PMCID: PMC8923679 DOI: 10.2147/ijgm.s329942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Waleed Ahmed Alghamdi
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Waleed Ahmed Alghamdi; Harold G Koenig, Email ;
| | - Ahmed Hussein Subki
- Department of Internal Medicine, King Faisal Specialist Hospital & Research center, Jeddah, Saudi Arabia
| | | | - Nadeem Shafique Butt
- Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rahaf Ali Alghamdi
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Ahmed A Alharbi
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Faten Al-Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Harold G Koenig
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
- School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China
- Duke University Medical Center, Durham, NC, USA
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Sucupira E, De Brito M, Leite AT, Aihara E, Neto MS, Ferreira LM. Body dysmorphic disorder and personality in breast augmentation: The big-five personality traits and BDD symptoms. J Plast Reconstr Aesthet Surg 2021; 75:3101-3107. [PMID: 35963769 DOI: 10.1016/j.bjps.2021.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 05/21/2021] [Accepted: 11/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Breast augmentation is one of the most performed cosmetic surgeries in the world. Personality traits predict the presence of psychological and social factors that may affect the patient satisfaction with a cosmetic surgical procedure and may be risk factors for body dysmorphic disorder. The aim of this study was to assess symptoms of body dysmorphic disorder in patients undergoing breast augmentation and identify their personality traits. METHODS Thirty-six women with hypoplasia of the breast (Sacchini index < 9 cm), a mean age of 28.1 years (SD = 6.2), body mass index ≤ 25 kg/m2, and no history of breast surgery or breast-associated conditions were included in this prospective study.The Brazilian versions of the Structured Clinical Interview (SCID-I), Big Five Inventory (IGFP-5), and Body Dysmorphic Symptoms Scale (BDSS) were applied preoperatively and at 2 and 4 months after breast augmentation. RESULTS Personality traits were associated with symptoms of body dysmorphic disorder. A significant decrease (p< 0.001) in IGFP-5 scores on the Conscientiousness dimension, symptoms of body dysmorphic disorder (BDSS scores), and the number of patients with body dysmorphic disorder (SCID-I) were observed among different time points. In the study population, breast augmentation decreased the symptoms of body dysmorphic disorder, psychosocial impairment, and mean scores on Conscientiousness. CONCLUSION Personality traits varied in intensity and overlapped over time, and were associated with core symptoms of body dysmorphic disorder and the onset of body dissatisfaction.
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Affiliation(s)
- E Sucupira
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Mja De Brito
- Institute of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil
| | - A T Leite
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Emk Aihara
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - M Sabino Neto
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - L M Ferreira
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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9
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Body Dysmorphic Disorder in Rhinoplasty Candidates: Prevalence and Functional Correlations. Aesthetic Plast Surg 2021; 45:641-648. [PMID: 32875438 DOI: 10.1007/s00266-020-01930-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Rhinoplasty is one of the most commonly performed aesthetic/functional procedures worldwide. Among those who seek rhinoplasty are those whose aesthetic defect is interpreted by themselves disproportionately, leading to significant suffering. These are given the diagnosis of body dysmorphic disorder (BDD). They commonly have high expectations regarding the surgical outcome and are often not satisfied postoperatively. The present study aimed to correlate BDD with the patient's self-assessment of nasal function, analysing whether BDD would have any influence on it. In addition, we verified the prevalence of the disorder in our population. METHODS Cross-sectional, comparative and analytical study. Eighty-eight patients participated in the trial, 57 of them being candidates for rhinoplasty, rhinoplasty group (RG), and 31 from a random population, control group (CG). Through self-assessment, the BDSS, The Utrecht, SNOT-22 and NOSE questionnaires were applied. Patients with BDSS score ≥ 6 were considered as positive for BDD. Comparisons were made between the groups and among the candidates for rhinoplasty with positive or negative BDD. RESULTS The prevalence of the disorder was 35.1% in the RG and 3.2% in the CG. Significantly, higher NOSE and SNOT-22 scores, reflecting worse nasal function, were obtained by the RG, especially in those with positive screening for BDD, when compared to those with negative screening (p < 0.05). CONCLUSIONS BDD affects about one-third of the rhinoplasty candidate population. Their presence seems to exert a negative influence on the patients' self-assessment regarding their nasal function. 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 .
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Avcu M, Metin M. Evaluation of the relationship between patient expectation, patient expectation coverage rates and patient satisfaction in open primary septorhinoplasty surgery: a prospective randomized study. Eur Arch Otorhinolaryngol 2021; 278:2337-2346. [PMID: 33389005 DOI: 10.1007/s00405-020-06502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to evaluate the relationship between preoperative patient expectation and postoperative patient expectation coverage rates and patient satisfaction. METHODS 183 patients who underwent SRP for various reasons were divided into 6 groups according to surgical indication and the postoperative Rhinoplasty Outcome Evaluation Scale (ROE). The groups were evaluated in terms of preoperative expectation levels and postoperative expectation coverage rate. RESULTS When the patients were evaluated in terms of preoperative expectation levels, a significant difference was determined between the patients who underwent surgery for cosmetic reasons (86.15 ± 8.61) and those with functional reasons (79.24 ± 6.62) (p < 0.001). Similarly, the lowest patient expectation coverage rates were in the patient group with cosmetic reasons for the operation. When patients were grouped according to the ROE scores in the postoperative period and surgical indication, expectation was higher in the groups that were not satisfied with the results (Groups 2, 4 and 6). The highest expectation levels among the groups were seen in the dissatisfied patients who had undergone surgery for cosmetic reasons (92.17 ± 4.96). A strong positive correlation was found between expectation coverage rates and patient satisfaction (r 0.907, p < 0.001). CONCLUSION Determination and rationalization of the expectations of patients in the preoperative period is one of the factors that will increase the satisfaction of the patients about the surgical procedure.
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Affiliation(s)
- Mustafa Avcu
- Department of Otorhinolaryngology, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey.
| | - Mehmet Metin
- Department of Otorhinolaryngology, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
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Morita MM, Merlotto MR, Dantas CL, Olivetti FH, Miot HA. Prevalence and factors associated with body dysmorphic disorder in women under dermatological care at a Brazilian public institution. An Bras Dermatol 2020; 96:40-46. [PMID: 33279313 PMCID: PMC7838121 DOI: 10.1016/j.abd.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/23/2020] [Indexed: 12/01/2022] Open
Abstract
Background Body dysmorphic disorder consists of excessive concern with minimal appearance defects, which causes functional impairment. Its prevalence is estimated to range from 5% to 35% of dermatological patients, especially adult women with esthetic complaints. Objectives To investigate the prevalence and factors associated with dysmorphic disorder in female dermatological patients, in a public institution in Brazil. Methods This was a cross-sectional study involving adult women attended at a public dermatological service in Brazil. Participants underwent a demographic survey, in addition to a screening form for body dysmorphic disorder (Body Dysmorphic Disorder Examination [BDDE]). The presence of dysmorphic disorder (BDDE > 66 points) was assessed among the participants according to demographic covariates and psychological problems, through logistic regression. Results A total of 223 women were evaluated. The BDDE showed high internal consistency (Cronbach’s α = 0.90). It is noteworthy the high prevalence of psychological problems and the fact that over one-third (38%) of the sample presented a high degree of dissatisfaction with their image. The prevalence of dysmorphic disorder was 48% among women with esthetic complaints and 30% among the others (p < 0.01). Lower family income (OR = 2.97), history of domestic violence (OR = 3.23), search for dermatological care due to an esthetic complaint (OR = 2.05), and suicidal ideation (OR = 4.22) were independently associated with the occurrence of body dysmorphic disorder. Study limitations This was a single-center study of a non-randomized sample from public service. Conclusions Body dysmorphic disorder is prevalent among female dermatological patients; it is associated with traumatic psychological experiences, lower income, affective disorders, and demand for esthetic care. It is essential to recognize the diagnosis in order to treat such patients and refer them for appropriate psychiatric treatment instead of trying to satisfy their esthetic demands.
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Affiliation(s)
| | | | | | | | - Hélio Amante Miot
- Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
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Gama ACV, Baptista TJR. O tema “imagem corporal” nas publicações do Scientific Electronic Library Online – SciELO: revisão integrativa. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i1.836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A imagem corporal é um tema que vem se ampliando nos últimos anos. Por isso, a partir de uma revisão integrativa da literatura efetuada na plataforma Scientific Eletronic Library Online, realizou-se uma pesquisa em 26 artigos publicados no ano de 2016, com o objetivo de identificar as principais características dos textos sobre imagem corporal. Os resultados apontam para três tipos de estudo predominantes: a) artigos de revisão; b) validação de instrumentos e protocolos e; c) análise dos níveis de satisfação/insatisfação com a imagem corporal de grupos distintos. A partir dessas informações, também foi possível concluir que são necessários novos estudos, sobretudo, vinculados às possíveis determinações sociais sobre a imagem corporal.
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Influence of Social Media on the Decision to Undergo a Cosmetic Procedure. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2333. [PMID: 31592374 PMCID: PMC6756652 DOI: 10.1097/gox.0000000000002333] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/03/2019] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text. There is a rise of cosmetic procedures in Saudi Arabia. Social media have become a popular means of advertisements for cosmetic professional providers. There are currently no studies that determine the relationship between viewing cosmetic surgery advertisements and considering undergoing cosmetic procedures in female university students in Saudi Arabia.
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High Prevalence of Body Dysmorphic Disorder and Moderate to Severe Appearance-Related Obsessive-Compulsive Symptoms Among Rhinoplasty Candidates. Aesthetic Plast Surg 2019; 43:1000-1005. [PMID: 30607575 DOI: 10.1007/s00266-018-1300-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Rhinoplasty is one of the most sought-after procedures in plastic surgery by individuals with body dysmorphic disorder (BDD). The identification of BDD symptoms is a challenge for plastic surgeons. The purpose of this study was to use a specific instrument for detection of BDD symptoms as a screening tool in rhinoplasty candidates and estimate the prevalence and severity of BDD symptoms in this population. METHODS Eighty patients of both sexes seeking rhinoplasty were consecutively recruited at a plastic surgery outpatient clinic of a university hospital from February 2014 to March 2015. In a clinical interview, 50 of them showed an excessive preoccupation with physical appearance associated with clinically significant subjective distress and were, therefore, selected to participate in the study. All participants were assessed using the Brazilian-Portuguese versions of the Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD-YBOCS) and the Body Dysmorphic Symptoms Scale (BDSS), which can be applied by plastic surgeons, who are laypersons in psychology/psychiatry. RESULTS Twenty-four (48%, 24/50) candidates had BDD symptoms, and 27 (54%, 27/50) showed moderate to severe appearance-related obsessive-compulsive symptoms. A strong correlation was found between the BDSS and BDD-YBOCS scores (r = 0.841, P < 0.001), and a strong agreement was observed between the BDSS cutoff point and body dysmorphic disorder symptom status (kappa = 0.822). CONCLUSIONS A high prevalence of BDD and moderate to severe appearance-related obsessive-compulsive symptoms was found among aesthetic rhinoplasty candidates. The BDSS may be used as a screening tool for BDD symptoms in plastic surgery patients. LEVEL OF EVIDENCE IV 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 .
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Perez-Garcia IC, Peñaranda A, Cobo R, Hernandez AV, Moubayed SP, Most SP. Spanish Translation, Cultural Adaptation, and Validation of the Standardized Cosmesis and Health Nasal Outcomes Survey Questionnaire. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2153. [PMID: 31044120 PMCID: PMC6467619 DOI: 10.1097/gox.0000000000002153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/19/2018] [Indexed: 11/30/2022]
Abstract
Background: The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire is a new instrument that was developed to evaluate both functional and cosmetic components of rhinoplasty. It is a reliable, consistent, and validated patient-reported outcome measure that is not available in Spanish. Methods: The SCHNOS questionnaire was forward translated, back translated, and culturally adapted following international guidelines. Its psychometric validity was tested with native Spanish speakers in 2 centers in Colombia. The authors measured internal consistency, correlation, and reproducibility to determine validity of the instrument. Results: The final Spanish version of the SCHNOS was administered to 76 native Spanish speakers. Both the SCHNOS-O (obstructive domain) and SCHNOS-C (cosmetic domain) showed a high internal consistency with Cronbach’s alpha of 0.84 and 0.94, respectively. The Spearman correlations between the items of SCHNOS-O (0.38–0.82) and SCHNOS-C (0.49–0.88) were positive and significant. Spearman’s rank correlation in the test–retest analysis for SCHNOS-O (r = 0.87) and SCHNOS-C (r = 90) was positive and statistically significant. There was statistical significance in responses obtained for SCHNOS-O (P < 0.001) but not for SCHNOS-C (P = 0.222). Conclusions: In this study, the SCHNOS was successfully translated and culturally adapted into Spanish. The Spanish version of the SCHNOS was shown to be a reliable and valid instrument that we recommend it should be used in Spanish-speaking patients who are having functional or cosmetic rhinoplasty.
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Affiliation(s)
- Irene C Perez-Garcia
- Division of Otolaryngology, Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia.,Clinical Teacher, Universidad de los Andes, Bogotá, Colombia
| | - Augusto Peñaranda
- Division of Otolaryngology, Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia.,Clinical Teacher, Universidad de los Andes, Bogotá, Colombia
| | - Roxana Cobo
- Division of Otolaryngology, Department of Surgery, Centro Médico Imbanaco Cali, Colombia
| | - Ana V Hernandez
- Otolaryngology, Fundación de Ciencias de la Salud, Bogotá, Colombia
| | - Sami P Moubayed
- Department of Otorhinolaryngology, Université de Montréal, Montréal, Québec, Canada
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, Calif
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Atallah MR, Milad D, Benamer YH, Saltychev M, Most SP, Moubayed SP. Translation, cultural adaptation and validation of the SCHNOS in French. J Otolaryngol Head Neck Surg 2019; 48:17. [PMID: 30894227 PMCID: PMC6425707 DOI: 10.1186/s40463-019-0339-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a validated questionnaire that assesses functional and aesthetic outcomes of rhinoplasty patients. There are 274 million French speakers worldwide, and this questionnaire is currently not available in French. The purpose of this study was to translate, adapt, and validate a French version of the SCHNOS questionnaire. METHODS The SCHNOS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. The final version was administered prospectively to 25 rhinoplasty patients and 25 controls at two-week intervals. It was then administered to 165 consecutive patients. Psychometric properties were evaluated using the Item Reponse Theory (IRT) and confirmatory factor analysis (CFA). RESULTS Three items from the original SCHNOS were modified to produce the French-SCHNOS (F-SCHNOS). Discrimination abilities of F-SCHNOS-O and F-SCHNOS-C were perfect, with values of 2.18(p < 0.001, 95% CI 1.74 to 2.62) for SCHNOS-O and 2.62(p < 0.001, 95% CI 2.03 to 3.21). Internal consistency was high, with Cronbach's alpha of 0.93 for F-SCHNOS-O and 0.95 for F-SCHNOS-C. IRT showed good psychometric properties with almost each step up or down across the scale associating with meaningful differences in outcome severity. All four SCHNOS-O items were equally "important" in defining the total score. The F-SCHNOS-C total score was defined by mostly four out of six items. CONCLUSIONS The SCHNOS was translated, adapted, and psychometrically validated for use in a French-speaking population.
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Affiliation(s)
- Marie-Renée Atallah
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Université de Montréal, Montréal, Québec, Canada.
| | - Daniel Milad
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Youcef-Hamza Benamer
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Sami P Moubayed
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Université de Montréal, Montréal, Québec, Canada
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Motoki THC, Isoldi FC, Brito MJDA, Filho AG, Ferreira LM. Keloid negatively affects body image. Burns 2018; 45:610-614. [PMID: 30429075 DOI: 10.1016/j.burns.2018.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/11/2018] [Accepted: 10/17/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND/OBJECTIVES Keloid is a healing disorder that occurs exclusively in humans. This pathology is considered a benign cicatricial neoplasm, whose physiopathogenesis has not yet completely clarified. Its disfiguring appearance often could potentially cause a disturbance in the patient regarding his/her body image. The objective is to evaluate the impact of keloid on body image. METHODS 61 patients with keloid in socially exposed regions of the body were included. The participants were submitted to clinical evaluation, composed of anamnesis and physical examination, and answered two questionnaires: the Body Dysmorphic Symptoms Scale (BDSS) questionnaire and the Rosenberg Self-Esteem Scale - Unifesp/EPM. RESULTS Forty percent of the patients had negative aspects of body image (BDSS score≥6). The scores of these patients on the Rosenberg Scale reached an average of 10.5 (p<0.03). CONCLUSIONS The presence of a keloid negatively affects body image.
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Affiliation(s)
| | - Felipe Contoli Isoldi
- Universidade Federal de São Paulo (UNIFESP/EPM) - Plastic Surgery Division, São Paulo, Brazil.
| | | | - Alfredo Gragnani Filho
- Universidade Federal de São Paulo (UNIFESP/EPM) - Plastic Surgery Division, São Paulo, Brazil
| | - Lydia Masako Ferreira
- Universidade Federal de São Paulo (UNIFESP/EPM) - Plastic Surgery Division, São Paulo, Brazil
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Higgins S, Wysong A. Cosmetic Surgery and Body Dysmorphic Disorder - An Update. Int J Womens Dermatol 2017; 4:43-48. [PMID: 29872676 DOI: 10.1016/j.ijwd.2017.09.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/21/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022] Open
Abstract
With the increasing volume and popularity of cosmetic procedures and surgeries, physicians in related specialties are increasingly likely to encounter patients with body dysmorphic disorder. Given the ethical, safety, and legal considerations involved in aesthetic procedures in these patients, accurate identification and appropriate selection for procedures is crucial.
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Affiliation(s)
- S Higgins
- Department of Dermatology, Keck Medicine of University of Southern California, Los Angeles, CA
| | - A Wysong
- Department of Dermatology, Keck Medicine of University of Southern California, Los Angeles, CA
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Sucupira E, Sabino M, de Lima EL, Dini GM, de Brito MJA, Ferreira LM. Short Mood and Feelings Questionnaire for screening children and adolescents for plastic surgery: cross-cultural validation study. SAO PAULO MED J 2017; 135:518-528. [PMID: 29116306 PMCID: PMC10016018 DOI: 10.1590/1516-3180.2017.0036030517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/03/2017] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Patient-reported outcome measurements assessing the emotional state of children and adolescents who seek plastic surgery are important for determining whether the intervention is indicated or not. The aim of this study was to cross-culturally adapt and validate the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) for Brazilian Portuguese, test its psychometric properties and assess the emotional state of children and adolescents who seek plastic surgery. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic at a public university hospital. METHODS A total of 124 consecutive patients of both sexes were selected between September 2013 and February 2014. Forty-seven patients participated in the cultural adaptation of the questionnaire. The final version was tested for reliability on 20 patients. Construct validity was tested on 57 patients by correlating the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) with the Strengths and Difficulties Questionnaire and the Rosenberg Self-Esteem scale. RESULTS The child/adolescent and parent versions of the Short Mood and Feelings Questionnaire showed Cronbach's alpha of 0.768 and 0.874, respectively, and had good inter-rater reliability (intraclass correlation coefficient, ICC = 0.757 and ICC = 0.853, respectively) and intra-rater reliability (ICC = 0.738 and ICC = 0.796, respectively). CONCLUSIONS The Brazilian-Portuguese version of the Short Mood and Feelings Questionnaire is a reproducible instrument with face, content and construct validity.The mood state and feelings among children and adolescents seeking cosmetic surgery were healthy.
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Affiliation(s)
- Eduardo Sucupira
- MD. Master’s Student, Postgraduate Program on Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Miguel Sabino
- MD, PhD. Associate Professor, Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Edson Luiz de Lima
- MD, MSc. Physician, Instituto Federal de Educação, Ciência e Tecnologia do Sul de Minas (IFSuldeMinas), Pouso Alegre (MG), Brazil.
| | - Gal Moreira Dini
- (in memoriam) PhD. Adjunct Professor, Postgraduate Program on Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Maria José Azevedo de Brito
- PhD. Affiliate Professor, College of Health Science, Universidade do Vale do Sapucaí (UNIVÁS), Minas Gerais; Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Lydia Masako Ferreira
- MD, PhD. Full Professor, Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
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