Abstract
Body Dysmorphic Disorder (BDD) is defined as a constant obsession with one’s external appearance and flaws, and it falls under the criteria of neuropsychiatric disorders. Individuals suffering from this disorder may seek unnecessary cosmetic procedures from cosmetic treatment providers such as dermatologists or plastic surgeons. Cosmetic treatments have become readily available, which has led to an influx of undiagnosed BDD patients electing to undergo such treatments. Therefore, physicians should have the clinical knowledge about BDD to diagnose and manage these cases to avoid psychological and physical harm to these patients. However, there were no studies conducted in our region to assess the awareness of BDD among physicians who provide cosmetic treatments with regards to their attitude toward such cases and how they would manage it. This study aims to assess the awareness of Body Dysmorphic Disorder among Saudi physicians who provide cosmetic treatments. We conducted an observational cross-sectional study among physicians practicing in hospitals and cosmetic clinics in Riyadh and Jeddah city (Saudi Arabia), who perform cosmetic procedures, namely dermatologists, plastic surgeons, and otorhinolaryngologists. A paper-based questionnaire consisting of multiple-choice questions was distributed among them. The total number of participants was 155 physicians: 113 (72.9%) males and 42 (27.1%) females. Eighty-two (52.9%) participants reported that they have been familiar with the diagnostic criteria of BDD for a long time and ninety-nine (63.8%) reported being familiar with the clinical picture of BDD. Sixty-three (40.6%) participants estimated the prevalence of BDD cases seen in cosmetic practice to range from 1%-5%, and most agreed on an equal prevalence of BDD among female and male patients. Half of the participants (n = 76) (49%) reported that they sometimes share knowledge about BDD with patients whom they suspect to suffer from this condition. In conclusion, cosmetic treatment providers in Saudi Arabia are aware of BDD, but we have identified a discrepancy between the self-reported participant knowledge of diagnostic criteria and their ability to accurately estimate the prevalence of BDD cases seen in clinical practice.
Highlights
Body Dysmorphic Disorder (BDD) is a neuropsychiatric disorder characterized by an irrational dissatisfaction with one’s external appearance along with a constant obsession over perceived physical flaws that might seem like a major defect to the patient while appearing unnoticeable or minor to others
We have constructed a questionnaire that is primarily based on Bouman et al study which assessed the awareness of the members of Dutch professional associations for aesthetic plastic surgery, dermatology, and cosmetic medicine of Body Dysmorphic Disorder (Bouman, Mulkens & Van der Lei, 2017), with minor modifications to fit the purpose of our study
The most commonly reported estimate of the prevalence of BDD in patients was 1–5%, with 70% of the participants seeing (0–5) BDD patients last year. It is statistically significant concerning the knowledge of the diagnostic criteria of BDD that 63 (40.6%) of participants claimed that they have certainly encountered patients with BDD over the past year
Summary
Body Dysmorphic Disorder (BDD) is a neuropsychiatric disorder characterized by an irrational dissatisfaction with one’s external appearance along with a constant obsession over perceived physical flaws that might seem like a major defect to the patient while appearing unnoticeable or minor to others. There are multiple symptoms and behavioral tendencies, all of which are related to repetitive preoccupation with physical appearance, which include: thinking about the perceived physical flaws, spending long hours of the day grooming, and constantly comparing one’s appearance with others (American Psychiatric Association, 1994). Screening tools such as the Body Dysmorphic Disorder Questionnaire (BDDQ) (Phillips, 2005), and diagnostic tools such as the DSM-5 (American Psychiatric Association, 2013), were useful and have since been implemented and widely used to estimate the prevalence of BDD in specific patients and the general population. While seeking cosmetic treatment is a symptom of BDD, a study conducted in 2002 has shown that the perceived prevalence of BDD in plastic surgery patients by members of the American Society for Aesthetic Plastic Surgery (ASAPS) was underestimated and believed to be 2.3% (Sarwer, 2002)
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