Abstract
Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001) and intra-rater reproducibility (ICC = 0.939; P < 0.001). Significant differences in total scores were found between patients with and without symptoms (P < 0.001). A strong correlation (r = 0.841; P < 0.001) was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.
Highlights
More than 221,000 rhinoplasty procedures were performed worldwide in 2013, mainly among Caucasians; about 163,600 of these procedures were performed on women.[1]
This shows the high level of social acceptance of esthetic surgery in general and of rhinoplasty in particular, as a means of physical enhancement in a culture in which physical attractiveness is highly valued, leading to greater concern regarding appearance based on an ideal standard body.[4]
Healthcare professionals who were experienced in managing patients with body dysmorphic disorder and rhinoplasty patients participated in the evaluation on this instrument.[27]
Summary
More than 221,000 rhinoplasty procedures (or nose operations) were performed worldwide in 2013, mainly among Caucasians; about 163,600 of these procedures were performed on women.[1]. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), body dysmorphic disorder can be described as preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to other people, and compulsive or repetitive behavior (e.g. checking one’s appearance in a mirror, excessive grooming, skin picking and seeking reassurance) or mental acts (e.g. comparing one’s appearance with that of others) in response to concerns regarding appearance It causes clinically significant distress or impairment in important areas of functioning, with symptoms that are poorly explained by normal concerns regarding physical appearance or by concerns regarding body fat or weight, among individuals meeting diagnostic criteria for eating disorders. Patients with body dysmorphic disorder may show different degrees of insight regarding their body.[4,6]
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