Body Dysmorphic Disorder Screening Research Articles

Screening for Body Dysmorphic Disorder in Plastic Surgery Patients.

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. 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. 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. 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. 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 .

An Evidence-based Pathway for Body Dysmorphic Disorder in Facial Aesthetics.

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 non-surgical 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 synthesised by summarising 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 synthesised 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 non-surgical 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.

Characteristics of piercing and screening for body dysmorphic disorder among individuals in Poland

Characteristics of piercing and screening for body dysmorphic disorder among individuals in Poland

THE PERCEPTION OF BODY DYSMORPHIC DISORDER IN RHINOPLASTY BY FACIAL PLASTIC SURGEONS

Rhinoseptoplasty is among the most performed aesthetic/functional procedures in the world. Among those who seek surgery are those whose aesthetic defect, real or imagined, is interpreted by themselves in a disproportionate way, leading to suffering and/or significant impairment of psychosocial functioning and quality of life. These are diagnosed with Body Dysmorphic Disorder (BDD). These are patients who commonly have high expectations regarding the surgical outcome and who are often not satisfied post-operatively. The objective of this study was to correlate the profile of the rhinoplasty surgeon with the perception of BDD in their daily practice, analyzing whether the professional’s profile influences the perception or approach of patients with body self-image disorders. This is a cross-sectional and analytical study carried out with 80 surgeons, who completed a questionnaire related to the surgeon’s profile, professionals’ level of knowledge about TDC and how they approach these patients. Results: There was a very similar distribution of respondents in terms of gender, with a slight predominance of male surgeons, the vast majority of whom were otorhinolaryngologists with up to two years of practice in the specialty. Most respondents stated that they were unfamiliar with BDD, not even carrying out the assessment or screening, and were unaware of the disorder’s diagnostic methods. Most participants reported having come across patients with BDD in the last year, including operating on them, and showing less satisfaction with the result of the procedure, which led to threats in some cases. The frequency of screening for Body Dysmorphic Disorder was associated with length of time in the profession, and having knowledge about BDD was also associated with years of practice in rhinoplasty and the number of annual rhinoplasties. Overall, having knowledge about TDC was associated with years of rhinoplasty practice, as well as with the number of rhinoplasties performed per year.

Screening for body dysmorphic disorder in esthetic practice

Screening for body dysmorphic disorder in esthetic practice

Evidence-based review: Screening body dysmorphic disorder in aesthetic clinical settings.

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. 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. 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. 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. 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.

BODY DYSMORPHIC DISORDER, SELF-OBJECTION AND COMPETITIVE ATTITUDE IN INDIVIDUALS APPLICATION TO DERMATOLOGY CLINIC

Abstract: Purpose: Body dysmorphic disorder is important because it is a frequently encountered disorder in the dermatological patient group. This research aims to understand the relationship between body dysmorphic disorder and selfobjectification and competitive attitude and related factors. Method: The study was interviewed with 43 people who applied to the dermatology outpatient clinic between July 2022 and September 2022. Body Dysmorphic Disorder Screening- Self-Assessment Form was used to evaluate body dysmorphic disorder symptoms, Objectified Body Consciousness Scale was used to evaluate self-objectification, Competitive Attitude Scale was used to measure understanding of competitiveness. Study data were evaluated with t-test in independent groups, one-way analysis of variance and correlation analysis. Results: In the study, it was determined that the average age of the individuals who applied to the dermatology outpatient clinic was 26.49 and 69.8% of them were women. There was a significant positive correlation between body dysmorphic disorder symptom severity and body monitoring (rp = 0.32, p<0.05) and comparison (rp = 0.43, p<0.005) sub-dimensions; significant and negative correlations were found between body dysmorphic disorder symptom severity and competitive pleasure (rp = -0.40, p<0.05) sub-dimension. Conclusion: It is seen that watching and comparing one’s own body has a negative effect on the severity of body dysmorphic disorder. Determining the factors that feed the body monitoring and comparison behaviors will increase the success in the treatment of the dermatological patient group.

PREVALENCE OF BODY DYSMORPHIC DISORDER AMONG FEMALE PATIENTS SEEKING COSMETIC PROCEDURES

Body dysmorphic disorder (BDD) is a psychiatric illness in which individuals with minimal or non-existent defects related to appearance worry immensely about their looks:which results in displaying significant distress and impairment in behavior and psychosocial functioning. Patients with BDD seeking cosmetic surgery are usually unsatisfied with the outcomes of the surgery. Therefore, it is important to study this phenomenon and increase awareness among physicians about the importance of assessing their patients before starting any cosmetic treatment. To assess the presence of BDD in patients undergoing cosmetic procedures, and to improve the awareness about BDD among providers of cosmetic treatment. This is a cross-sectional study that uses the adult version of the BDD modification of the Y-BOCS (BDD-YBOCS) scale. This scale consists of 12 items related to preoccupied thoughts that participants have about their appearance, and the effects that these thoughts have on their lives. In this study, participants were instructedto answer questions on a 5-point Likert-type scale. Questionnaires were distributed on different online platforms, among females living in the eastern province of Saudi Arabia. Out of these, responses were received from 220participants. Out of the 220 women who participated in this cross-sectional study, 45 of them had BDD (prevalence rate of 20.5%), which is a significant percentage. The results of the study indicate that BDD is more prevalent among participants in the age group of 20–35 years. The study also revealed that a positive correlation exists between BDD and females seeking cosmetic procedures. we found thatOne-fifth of the participants were diagnosed to be suffering from BDD. Higher rates of BDD were observed among women who underwent cosmetic procedures. Therefore, we recommend physicians to conduct a BDD screening for patients seeking cosmetic procedures before treatment.

Prevalence of Body Dysmorphic Disorder among Female Patients Seeking Cosmetic Procedures

Background: Body dysmorphic disorder (BDD) is a psychiatric illness in which one’s with minimal or non-existing defect in appearance shows significant distress and impairment in behavior and psychosocial functioning. Patients with body dysmorphic disorder seeking cosmetic surgery are usually unsatisfied with the outcomes of the surgery; this is why it is an important subject to be focused on. Moreover, physicians should consider the assessment of body dysmorphic disorder before undergoing any cosmetic procedures. Objective: To assess Body Dysmorphic Disorder in patients undergoing cosmetic procedures, and to improve the awareness of Body Dysmorphic Disorder among the providers of cosmetic treatment. Methods: This is a cross sectional study design, using the scale of body dysmorphic disorder modification of the Y-BOCS (BDD-YBOCS) adult version, consisting of 12 items regarding preoccupied thoughts of the participants and the effect on their lives. This scale individual respond to the light of the 5-point Likert-Type scale. We received 220 sample after distributing the questionnaire in different online platforms among females living in the eastern province of Saudi Arabia. Results: A total of 220 females participated in this cross-sectional study, 45 of them had Body Dysmorphic Disorder (prevalence rate of 20.5%) which shows a significant worrying percentage. Moreover, the results indicate that Body Dysmorphic Disorder is more among participants in the (20-35) year’s old age group. Furthermore, it shows a positive correlation between Body Dysmorphic Disorder and females seeking cosmetic procedures. Conclusion: we recognized that one-fifth of the participants were diagnosed with Body Dysmorphic Disorder. Whereas higher rates among those who underwent cosmetic procedures were detected. Therefore, we recommend implementing a Body Dysmorphic Disorder screening tool for patients seeking cosmetic procedures before undergoing it.

Screening for Body Dysmorphic Disorder among Patients Seeking Dermatological and Cosmetic Care: A Cross-sectional Study.

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Screening for body dysmorphic disorder among patients pursuing cosmetic surgeries in Saudi Arabia.

Objectives:To determine the prevalence of positive screening of body dysmorphic disorder (BDD) among patients seeking cosmetic surgeries in plastic surgery and oculoplastic surgery clinics.Methods:The survey of this cross-sectional study was self-administrated and distributed among adults pursuing cosmetic surgeries in plastic surgery and oculoplastic surgery clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between March 2019 and March 2020. The BDD questionnaire was validated, and a highly sensitive and specific tool was used to identify patients with BDD. Ethical approval was granted by the Research Ethics Committee. All analytic studies were performed using IBM SPSS, version 24.Results:A total of 344 patients participated in this study with a mean age of 39.66 ± 13.76 years. Of these, 296 (86%) were women and 298 (86.6%) were Saudi. The prevalence of positive screening for BDD was 19.2%. The most commonly requested procedures were abdominoplasty (21.2%) and skin lesion removal (21.2%). Smoking was found to be significantly associated with BDD with 21.2% of smokers having it (p<0.010).Conclusion:Body dysmorphic disorder was unrecognized among patients pursuing cosmetic surgeries. One-fifth of patients requesting cosmetic procedures are potential cases of BDD requiring psychiatric evaluation and treatment. We recommend implementing screening protocols to identify cases before surgical plans.

Body Dysmorphic Disorder in Rhinoplasty Candidates: Prevalence and Functional Correlations.

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. 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. 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). 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. 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 .

Cosmetic Procedure Screening Questionnaire (COPS): creation and validation of the Polish language version.

IntroductionBody dysmorphic disorder (BDD) is a disabling mental disorder characterized by excessive preoccupation with appearance. Trying to fix imagined defects many individuals with BDD search for aesthetic dermatology treatments. Due to omitting preliminary evaluation for BDD in subjects undergoing cosmetic procedures and lack of proper diagnostic tools among this group of individuals, the results of such interventions may face their disapproval and disappointment.AimTo translate and validate the Polish version of a Cosmetic Procedure Screening Questionnaire (COPS), which can be used in a cosmetic procedure setting to screen patients suspected to be suffering from BDD.Material and methodsBoth forward and backward translations of the original English version of the questionnaire to Polish were performed in accordance with international standards. The validation was conducted on 33 individuals undergoing aesthetic procedures, who completed the questionnaire twice with 3–6 days’ interval. Moreover, the subjects were also asked to fill the Polish versions of BIQLI (Body Image Quality of Life Inventory) and HADS (Hospital Anxiety and Depression Scale) for convergent validity procedure.ResultsThe Polish version of COPS demonstrated good internal consistency (Cronbach α coefficient value of 0.76) and reproducibility (Intraclass Correlation Coefficient, ICC, of 0.79). COPS correlated strongly with BIQLI (r = –0.66, p < 0.01) as well as with HADS, in both depression and anxiety subscales (r = 0.68, p < 0.01 and r = 0.66, p < 0.01, respectively).ConclusionsThe Polish version of the COPS questionnaire showed sufficient internal consistency and reliability. It can be used for BDD screening among the Polish speaking subjects undergoing aesthetic dermatology procedures.

Magnitude and determinants of body dysmorphic disorder among female students in Saudi public secondary schools.

ObjectivesRecent estimates have indicated that the weighted community prevalence of body dysmorphic disorder (BDD) is rising. This study aimed to identify the prevalence and determinants of BDD among female adolescents in Jeddah, KSA.MethodsA cross-sectional study was conducted among female students in governmental secondary schools. Students presenting with abnormal health conditions were excluded. A multi-stage stratified sampling technique was used to select the target number of students (N = 495). BDD screening was performed using a BDD questionnaire.ResultsThe students’ mean (standard deviation) age was 16.78 (1.11) years, and the prevalence of BDD was 12.3% (95% confidence interval: 9.6–15.5%). The body parts associated with the most concern were the skin (18.4%), hair (10.7%), teeth (9.9%), and nose (9.5%). Psychosocial assessment showed that the body part of concern was associated with sadness in 20.6%, avoidance reactions in 17.6%, and problems in school, work, or other activities in 3.8% while playing a role in social relationships in 21.5%. The aspects associated with the highest risk included the skin (odds ratio (OR) = 8.33, p < 0.001), followed by body fat (OR = 8.17, p < 0.001) and the nose (OR = 7.35, p < 0.001). With the number of affected body parts, the prevalence of BDD increased from 21.7% (one body part) to 60%.ConclusionsIn this study, BDD was a common, difficult-to-recognise disorder with a prevalence of one in eight female Saudi adolescents. It was associated with marked changes in social interactions, self-esteem, and quality of life.

Body dysmorphic disorder in female Swedish dermatology patients.

Individuals with body dysmorphic disorder (BDD) are highly distressed and impaired owing to perceived defects in their physical appearance that are not noticeable to others. They are frequently concerned about their skin and often present to dermatologists rather than psychiatrists. However, BDD patients attending dermatology clinics may be at risk of not receiving an appropriate assessment and beneficial treatment. The aims of this study were to estimate the BDD prevalence rate among Swedish female dermatology patients and to assess the psychological condition of BDD patients compared to that of other dermatology patients. The occurrence of BDD was estimated using the Body Dysmorphic Disorder Questionnaire (BDDQ), a validated self-report measure for BDD. Symptoms of depression and anxiety were measured by the Hospital Anxiety and Depression Scale (HADS), and quality of life was assessed using the Dermatology Life Quality Index (DLQI). The prevalence rate of BDD among female Swedish dermatology patients was 4.9% (95% CI 3.2-7.4). Anxiety (HADS A≥11) was 4-fold more commonly reported by patients with positive BDD screening (48% vs. 11%), and depression (HADS D≥11) was over 10-fold more common in patients with positive BDD screening (19% vs. 1.8%) (P<0.001). The median DLQI score was 18 in the BDD group, compared to a score of 4 in the non-BDD group (P<0.001). Our results indicate that BDD is fairly common among female Swedish dermatology patients (4.9%) and that BDD patients have high levels of depression and anxiety and severely impaired quality of life.

Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented. To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD. This multicenter prospective study recruited a cohort of 597 patients who presented to academic and private facial plastic and oculoplastic surgery practices from March 2015 to February 2016. All patients were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ). After each clinical encounter, surgeons independently evaluated the likelihood that a participating patient had BDD. Validated instruments were used to assess satisfaction with facial appearance including the FACE-Q, Blepharoplasty Outcomes Evaluation (BOE), Facelift Outcomes Evaluation (FOE), Rhinoplasty Outcomes Evaluation (ROE), and Skin Rejuvenation Outcomes Evaluation (SROE). Across participating practices (9 surgeons, 3 sites), a total of 597 patients were screened for BDD: 342 patients from site 1 (mean [SD] age, 44.2 [16.5] years); 158 patients, site 2 (mean [SD] age, 46.0 [16.2] years), site 3, 97 patients (mean [SD] age, 56.3 [15.5] years). Overall, 58 patients [9.7%] screened positive for BDD by the BDDQ instrument, while only 16 of 402 patients [4.0%] were clinically suspected of BDD by surgeons. A higher percentage of patients presenting for cosmetic surgery (37 of 283 patients [13.1%]) compared with those presenting for reconstructive surgery (21 of 314 patients [6.7%]) screened positive on the BDDQ (odds ratio, 2.10; 95% CI, 1.20-3.68; P = .01). Surgeons were only able to correctly identify 2 of 43 patients (4.7%) who screened positive for BDD on the BDDQ, and the positive likelihood ratio was only 1.19 (95% CI, 0.28-5.07). Patients screening positive for BDD by the BDDQ had lower satisfaction with their appearance as measured by the FACE-Q, ROE, BOE, SROE, and FOE. Body dysmorphic disorder is a relatively common condition across facial plastic and oculoplastic surgery practice settings. Patients who screen positive on the BDDQ have lower satisfaction with their facial appearance at baseline. Surgeons have a poor ability to screen for patients with BDD when compared with validated screening instruments such as the BDDQ. Routine implementation of validated BDD screening instruments may improve patient care. NA.

Motivational Factors of Women Seeking Labiaplasty and Body Dysmorphic Disorder Risk: A Review

Objective: The objective of this study is to explore the childbearing. Background: Until recently very little was known about women’s reasons for undergoing labiaplasty. Cosmetic treatment is often solution for individuals with unrecognized Body dysmorphic disorder (BDD). Body dysmorphic disorder (BDD) is a relatively common psychiatric disorder that occurs around the world and often goes unrecognized in plastic surgery setting. Objectives: The present review examines actual knowledge of motivational factors of women seeking labiaplasty and BDD, what is known about motivational factors of women underwent labiaplasty and about BDD in plastic surgery setting, approach to the patients seeking labiaplasty and screening for BDD in a gynaecologic cosmetic surgery field. Methods: Data sources and searches: We carried out a systematic electronic search in Medline, Web of Science and PubMed. We used a combination of relevant keywords to construct the search strategy including cosmetic surgery in gynaecology, female genital cosmetic surgery, labiaplasty, motivational factors of women seeking labiaplasty, body dysmorphic disorder, screening tools for body dysmorphic disorder, diagnosing BDD. Included studies were systematic reviews or primary studies of participants requesting cosmetic procedure labiaplasty; published 1990-2016; containing either information about BDD and psychological or psychosocial measures and psychological outcome. There were retrieved total of 50 papers and 20 of them published in last ten years were used for describing motivational factors and BDD risk. Reviewers independently assessed study eligibility, extracted data, and assessed quality, undertaking narrative synthesis. Results: The recent researches revealed why women consider undergoing labia reduction surgery. Researchers categorized them as cosmetic, functional, psychological and sexual. It was also confirmed that media is a powerful motivator and source of information about genital appearance and strong influence on women’s decision to undergo labiaplasty. However, some women seeking labiaplasty may have Body dysmorphic disorder (BDD). BDD is a psychiatric disorder that needs appropriate psychiatric treatment and patients with BDD need suitable therapeutic interventions like psychological counselling or special psychiatric treatment. The disorder is giving the markedly poor functioning and quality of life. It also could relate to high lifetime rates of psychiatric hospitalization, being housebound or suicide attempts. Cosmetic treatment is not solution for individuals with unrecognized BDD because after surgery patients are often dissatisfied and continue to obsess about their perceived flaws. Guidelines recommend screening patients for BDD prior to cosmetic surgery. Conclusions: Motivational factors of women seeking labiaplasty are various. Some patients may have Body dysmorphic disorder (BDD). Psychological evaluation of patients with BDD is not standard in clinical plastic surgery nowadays. BDD needs to be identified before surgery in patients who are seeking cosmetic corrections and it is necessary to identify those who may require further psychological assessment. There is a grooming consensus that BDD should be considered as a contraindication for cosmetic treatments. Clinicians should use a multidisciplinary approach in management, including cooperation among specialists in dermatology, psychiatry, cosmetic surgery, family practice and other specialties.

Screening for Body Dysmorphic Disorder in a Dermatology Outpatient Setting at a Tertiary Care Centre.

Context:A distressing pre-occupation with an imagined or slight defect in appearance with a marked negative effect on the patient's life is the core symptom of body dysmorphic disorder (BDD).Aim:To screen the patients attending a dermatology clinic at a tertiary care centre for BDD using the BDD-dermatology version (DV) questionnaire.Settings and Design:This cross-sectional study enrolled 245 consecutive patients from the dermatology outpatients clinic.Methods:The demographic details were collected and the DV of BDD screening questionnaire was administered. A 5-point Likert scale was used for objective scoring of the stated concern and patients who scored ≥3 were excluded from the study.Statistical Analysis Used:The results were statistically analysed. Differences between the groups were investigated by Chi-square analysis for categorical variables, and Fisher exact test wherever required.Results:A total of 177 patients completed the study, and of these, eight patients screened positive for BDD. The rate of BDD in patients presenting with cosmetic complaints was 7.5% and in those with general dermatology, complaints were 2.1%, with no significant difference between the two groups (P = 0.156). Facial flaws (62.5%) were the most common concern followed by body asymmetry (25%).Conclusion:The rates of BDD found in this study are comparable but at a lower rate than that reported in literature data.

Body dysmorphic disorder in a facial plastic and reconstructive surgery clinic: measuring prevalence, assessing comorbidities, and validating a feasible screening instrument.

Body dysmorphic disorder (BDD) is underrecognized and underdetected among patients undergoing facial plastic and reconstructive surgery. Patients with BDD require psychiatric care, not cosmetic surgery. To measure the prevalence of BDD in a facial plastic and reconstructive surgery clinic, to validate the Body Dysmorphic Disorder Questionnaire (BDDQ) in that setting, to assess the feasibility of implementing a standardized process for identifying patients with BDD accurately in a busy clinical practice, and to assess the comorbidity of BDD, depression, and anxiety in our patient population. We performed a prospective prevalence and instrument validation study in an academic facial plastic and reconstructive surgery clinic. We included 234 consecutive patients 18 years or older presenting to the clinic from March 3 to June 30, 2014. Prevalence of BDD as determined by the BDDQ and the criterion-standard BDD Structured Clinical Interview for DSM-IV (BDD SCID). The BDD SCID and a defect severity scale were used to confirm the BDD diagnosis and to validate the BDDQ finding. We also assessed demographic characteristics, depression, and anxiety in all patients. As confirmed by the BDD SCID, 13.1% of patients undergoing cosmetic surgery and 1.8% of those undergoing reconstructive surgery had BDD. We found the BDDQ to be an accurate (91.7%), sensitive (100%), and specific (90.3%) screening instrument for BDD. Patients with a positive BDD finding were most commonly concerned with their nose (10 of 18 [56%]), skin (5 of 18 [28%]), hair (1 of 18 [6%]), chin (1 of 18 [6%]), and ears (1 of 18 [6%]), that is, areas commonly addressed by facial plastic surgeons. Furthermore, compared with patients who did not have BDD, patients with BDD had elevated depression scores (mean [SD], 12.6 [10.8] vs 3.2 [4.2]). In the non-BDD population, mean (SD) state and trait anxiety scores resembled the norm (30.0 [7.7] and 30.3 [7.7], respectively, for men; 31.7 [10.0] and 32.1 [8.7], respectively, for women); in the BDD population, these scores were elevated (53.8 [23.4] and 50.4 [19.5], respectively, for men; 47.8 [12.7] and 49.0 [11.6], respectively, for women). Depression and anxiety scores were highly correlated in patients with BDD (r = 0.84 for patients with a BDDQ-positive screen result; r = 0.94 for patients with a positive BDD SCID finding) compared with those who did not have BDD (r = 0.51). Patients with BDD often seek cosmetic treatment. Given the documented risks and harms of surgery for patients with BDD, a systematic process for identifying such patients who seek cosmetic surgery is imperative. We found a BDD screening instrument (BDDQ) followed by the BDD SCID for patients with a BDDQ-positive screen result to be a feasible and effective way to identify patients with BDD. NA.

Body dysmorphic disorder and psychological distress in orthognathic surgery patients

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 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 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.