Dysmorphic Disorder In Patients Research Articles

Gambaran Body Dysmorphic Disorder Pasien Perawatan Estetika Gigi di RSGM-P FKG Universitas Trisakti

Background: Body dysmorphic disorder is a psychiatric disorder related to physical appearance and is commonly found in dental aesthetic treatment. Some signs of a tendency toward BDD are obsessive behaviour towards imperfect physical appearance, repetitive behaviour, trying to cover up physical defects, and so on. Dental treatment for these patients' aesthetic complaints will not improve their problems. Objective: To describe the symptoms of body dysmorphic disorder in patients with aesthetic dental treatment. Methods: The study was conducted on aesthetic dental treatment patients at RSGM-P Faculty of Dentistry, Trisakti University. This type of research is descriptive observational. The total sampling technique was used to determine the sample, by distributing hardcopy Dysmorphic Concern Questionnaire offline to 40 respondents. Results: It was found that 80% of all respondents had a tendency towards body dysmorphic disorder. This tendency was most commonly found in female respondents, in the late adolescent, and adult age groups and the majority were in fixed denture treatment. The symptoms that occur are very concerned about several aspects of physical appearance. Conclusion: The most common symptom found in the majority of respondents with a tendency towards BDD in this study was obsessive thoughts that they are very concerned about several aspects of their physical appearance.

Body Dysmorphic Disorder in Patients with Cosmetic Concern Attending Dermatology Clinics: A Study of Prevalence, Demographic Correlates, and Psychiatric Comorbidity

Abstract Objectives: In this study, we intended to screen the patients who were attending dermatology clinics with cosmetic concerns for body dysmorphic disorder (BDD) to determine the prevalence of BDD and psychiatric comorbidity in patients suffering from BDD, as well as to study the association of BDD with various sociodemographic factors. Methods: We did a cross-sectional study at the dermatology clinic of a tertiary care government hospital in Vadodara. We screened 2,500 patients with BDD Questionnaire-Dermatology version (BDDQ-DV). Those screened-positive patients with BDD were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Psychiatric comorbidity was screened using General Health Questionnaire-28 and diagnosed using DSM-5. Results: Out of 2,500 patients, 315 screened positive for BDD using the BDDQ-DV scale. Totally, 42 (13.3%) were diagnosed with BDD. BDD was found more in adolescents younger, unemployed, females, with a family history of psychiatric illness and in the urban population. Among 42 BDD patients, 23 had generalized anxiety disorder, 15 had major depressive disorder, and 7 had combined features of both. Among BDD patients, we found that significantly more younger patients had general anxiety disorder (p < 0.05) and significantly more older patients had major depressive disorder (p < 0.05). Conclusion: The prevalence of BDD was 13.3%. Among BDD patients, psychiatric comorbidities were also observed. Dermatologists and mental health professionals should work together to prompt diagnosis and timely referral to a psychiatric facility for proper management and evaluation of psychiatric comorbidities.

Body dysmorphic disorder in patients with skin conditions

British Journal of DermatologyVolume 187, Issue 1 p. e51-e51 Plain Language Summary Body dysmorphic disorder in patients with skin conditions First published: 03 July 2022 https://doi.org/10.1111/bjd.21285AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked Article: Schut et al. Br J Dermatol 2022; 187:115–125. Body dysmorphic disorder (BDD) is a mental health condition affecting about 2·5% of the general population. Patients with this condition are preoccupied with negative thoughts about their own appearance, which can have a negative impact on their daily lives. Skin diseases can cause problems with psychological wellbeing, possibly because of visible skin lesions making people feel self-conscious. BDD has been shown to affect patients with dermatological conditions, but there are no large studies including patients with different dermatological conditions and also people with healthy skin. This study included almost 8295 adult participants: 5487 patients with different skin conditions (56% women) recruited from dermatological outpatient departments at 22 clinics in 17 European countries, and 2808 people with healthy skin (66% women). Symptoms of BDD were measured using a questionnaire that patients completed themselves. In addition, patients were given a dermatological diagnosis by a dermatologist. It was shown that BDD symptoms were five times more common in patients with dermatological conditions than in people with healthy skin (11% versus 2%). Patients with certain conditions, for example those with excessive sweating, hair loss and vitiligo, had an even higher chance of having BDD symptoms. The study found that BDD symptoms occurred more frequently in younger people, in women, and people with higher psychological stress and with experience of stigmatization (being viewed in a negative way because of their condition). As BDD symptoms are common in patients with dermatological conditions, general practitioners and dermatologists should consider whether patients may have both BDD and appearance-related distress. If so, they should refer patients to an appropriate service for further assessment and management. Volume187, Issue1July 2022Pages e51-e51 RelatedInformation

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.

Body dysmorphic disorder in patients with acne: treatment challenges.

Body dysmorphic disorder in patients with acne: treatment challenges.

Body dysmorphic disorder and personality in breast augmentation: The big-five personality traits and BDD symptoms

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. 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. 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. 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.

Skin Deep? : A scoping literature review of the psychological impact of Acne Vulgaris on patients and the role of the Psychiatrist

AimsThis literature review aims to assess existing scientific literature on the psychological impact of Acne Vulgaris on adolescents and adults and the role that Psychiatrists can play in supporting these patients. The hypothesis of this literature review is that all patients with Acne Vulgaris should have their quality of life assessed in order to identify those who require additional support.BackgroundThe link between Psychiatry and Dermatology is becoming increasingly recognised. Resources on the British Association of Dermatologists’ website are often distributed to patients by Dermatologists in order to assess the impact that a skin condition has had on a patient's life. Acne Vulgaris is a psychophysiological skin condition that impacts up to 95% of people to some extent from the ages of 11 to 30 years old. Due to its prevalence it is essential that the psychological burden of Acne Vulgaris on patients is understood.MethodLiterature written since 2011 was searched identified from: PsychINFO, MEDLINE, EMBASE, CINAHL and PUBMED. The search strategy key words were: acne vulgaris, mental health, psychiatry, anxiety and depression. Arksey and O'Malley's framework was utilised to conduct a scoping literature review. Data were collated and summarized thematically.ResultA total of 72 studies were included representing over 14,000 adults and adolescents with Acne Vulgaris from the following countries: Egypt, Nigeria, Turkey, India, Lithuania, UK, USA, Iran, Pakistan and Spain.Screening tools such as the Global Acne Grading System (GAGS), The Acne Quality of Life Scale (AQLS), the Cardiff Acne Disability Index (CADI), and the State Trait Anxiety Index STAI (Y-1) form were utilised in order to identify the impact of Acne Vulgaris on patients’ quality of life and mental health. The data clearly showed the significant psychological burden that patients with Acne Vulgaris can experience. There was a clear trend of low self-esteem, lack of self-confidence, social withdrawal, depression (ranging from 23.1% to 62% of study participants), anxiety (ranging from 38.4% to 51%) and even suicidal ideation (ranging from 12.9% to 20.1%). Literature also suggested a higher prevalence of Body Dysmorphic Disorder in patients with Acne Vulgaris which should be considered and screened for.ConclusionThis scoping literature review has highlighted the significant psychological burdensome acne patients can experience. Given the prevalence of the condition Psychiatrists do have a role in working with Dermatologists to ensure appropriate screening tools are utilised and patients are able to access appropriate support.

Assessment of body dysmorphic disorder in patients with anorexia nervosa and bulimia nervosa. The final data of the study

IntroductionAnorexia nervosa (AN) and bulimia nervosa (BN) occur predominantly females, take one of the first places in the risk of fatal outcome among mental disorders, have a tendency to chronicity, disability with social disadaptation, high suicidal risk. The psychopathological basis of these diseases is dysmorphophobia, characterized intrusive, overvalued or delusional ideas of physical disability. The significant role of dysmorphophobia determines the urgency of the detailed study using psychometric techniques.ObjectivesAssess the degree of satisfaction/dissatisfaction with one’s body and its separate parts in patients with AN and BN.Methods130 female patients with AN and BN at the age of 13-44 years (the average age is 18). The disease duration from 6 months to 24 years. The psychometric method using the validated Questionnaire image of one’s own body (QIOB) and the Scale of satisfaction with one’s body (SSOB).ResultsAccording to QIOB 84,62% in the category expressed dissatisfaction with their appearance, 15,38% in moderate category. According to SSOB, 32,31% of the patients is not satisfied with characteristics that belong to head, 45,38% is not satisfied with characteristics that belong to torso, 56,92% is not satisfied with characteristics that belong to the lower part of body. The number of dissatisfied with all of these body parts equals 38% which indicates the presence of polydismorfofobia.ConclusionsHigh rates of dissatisfaction with one’s appearance, which are consistent with the severe somatic state of patients, affect the dynamics and outcome of the disease. Publication was prepared with support of the “RUDN University Program 5-100”.

Role of Body Dysmorphic Disorder in Patients With Postparalytic Facial Synkinesis.

To evaluate the role of body dysmorphic disorder (BDD) in patients with postparalytic facial nerve syndrome with synkinesis (PFS). A single-center retrospective cohort study. A total of 221 adults (74% women; median age: 44 years; median duration since onset of facial palsy: 1.6 years) were included. To diagnose BDD, the BDD Munich Module was used. Associations with House-Brackmann grading, Stennert index grading, Facial Clinimetric Evaluation (FaCE) survey, Facial Disability Index (FDI), general quality of life (SF-36), Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) was analyzed. A total of 59 patients (27%) were classified as patients with BDD. Significant associations were found between the diagnosis of BDD and female gender and lower FDI, FaCE, and SF-36 scores and higher BDI and LSAS scores. Multivariate analysis revealed BDI, FaCE total score, and FaCE social function subscore as independent factors associated with BDD. BDD was a relevant diagnosis in patients with PFS. A higher BDD level was associated with general and facial-specific quality of life and more psychosocial disabilities. Optimal treatment of PFS has to include these nonmotor dysfunctions. 3 Laryngoscope, 131:E2518-E2524, 2021.

Identification of Body Dysmorphic Disorder in Patients Seeking Corrective Procedures From Oral and Maxillofacial Surgeons.

Body dysmorphic disorder (BDD) is an obsessive-compulsive related disorder characterized by an individual's preoccupation with the appearance of at least 1 perceived physical flaw. The bodily concerns held by individuals with BDD are largely unnoticeable, if at all, to other individuals. Those living with BDD are compelled to engage in repetitive behaviors or cognitive acts that interfere with daily function and activities. Despite the high prevalence of BDD in patients who seek cosmetic procedures (ie, as high as 1 in 5 such patients) and the availability of validated screening tools for this disorder, implementing a protocol of regularly screening for BDD is only rarely practiced by surgeons. Few studies have investigated its prevalence in the setting of elective dentoalveolar and orthognathic procedures. With the scope of practice of maxillofacial surgeons expanding in recent years to include facial cosmetic procedures, it is becoming increasingly important to screen for such disorders so that patients and physicians can appropriately weigh the risks and benefits of surgical intervention. We conducted a cross-sectional cohort study (n = 46) consisting of 3 groups of patients, who were seeking either facial cosmetic, orthognathic, or dentoalveolar procedures. All patients in the study were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ) and assessed for severity of disorder using the BDDQ severity scale. Additional patient variables included age, sex, history of psychiatric diagnosis, primary diagnosis, and type of operation/procedure being sought. Among the 3 groups, patients seeking dentoalveolar surgery were the most represented (67%) in this sample, followed by cosmetic surgery (27%) and orthognathic surgery (6%). Twenty-six female participants and 20 male participants were included, with an overall mean age of 38 years. Two percent of participants carried a previous psychiatric diagnosis and 10.8% of the sample were classified as high-risk for BDD. The group containing the highest proportion of patients at high-risk for BDD were those seeking facial cosmetic procedures (16.7%), followed by those seeking dentoalveolar procedures (10%); none of the patients seeking orthognathic procedures were found to be at high-risk for BDD (0%). The BDDQ is an efficient way to screen for BDD in patients who are seeking orthognathic or facial cosmetic surgery. In our sample, patients presenting to maxillofacial surgeons for facial cosmetic surgery were found to score significantly higher on the BDDQ than those presenting for dentoalveolar surgery. In contrast to results of previous literature, patients seeking orthognathic surgery in our sample demonstrated no elevated risk for BDD, a finding which may be attributable to our small sample size. Ultimately, the data obtained from this study can aid surgeons in identifying patients with BDD in their own surgical practice, so that they may appropriately triage patients who may, or may not, benefit from surgical intervention.

Body dysmorphic disorder in patients with telangiectasias.

Chronic venous disease (CVD) patients can present with a spectrum of clinical manifestations ranging from severe ulcerations, thrombosis, and varicose vein hemorrhage to milder ones such as telangiectasias. Some CVD patients have a minimal degree of telangiectasias that are almost invisible to the physician. In spite of successful treatment of these telangiectasias, there are patients that might insist on continuing treatment, focusing excessive attention on what they perceive to be persistent telangiectasias that, in their opinion, must be removed. In these cases, one might be facing a possible body dysmorphic disorder (BDD) diagnosis. This is a multicentric study performed in 223 patients with telangiectasias (C1s) seeking treatment; the Body Dysmorphic Disorder Questionnaire (BDDQ) was answered in private by all the patients. Furthermore, each questionnaire was evaluated in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for BDD. From a consecutive sample of 223 patients, 38 patients had criteria for BDD according to the DSM-V; indicating that the prevalence of BDD in patients with telangiectasias is 17%. Telangiectasias can be a stress trigger that changes the way patients perceive their own appearance. BDD patients tend to focus their attention excessively upon these types of veins and demand unnecessary treatment for minimal telangiectasias in order to diminish their discomfort with their physical appearance. Body dysmorphic disorder occurs in patients with limbs with C1s disease in considerable proportion and, upon evaluation, these patients should be referred to a psychiatrist. The initiation of any treatment for telangiectasias prior to the psychiatric assessment should be avoided.

Psychiatric profile, depression and body dysmorphic disorder in patients with amputation

Introduction: Amputation due to trauma is a catastrophic injury and causes major disability in most of the cases. Loss of limb is associated with low self-esteem, body image disturbance, social isolation and also a sense of stigmatization. In many conditions amputation is unavoidable. Irrespective of the aetiology, amputation is considered as a mutilating surgery and it affects the lives of the patients. Limb amputation is a more commonly occurring event in the present society. In this present study, we are going to study socio-demographic profile and psychiatric morbidities of patients with amputation. Materials and Methods: In cross sectional study, a total of 30 consecutive patients with amputation were chosen and assessed within the period of two to six weeks after amputation. Results: Our results showed that psychiatric morbidity is high in amputated patients. High scores of depression and anxiety were found in all patients and also considerable percentage of the sample had a high score on Body Dysmorphic disorder rating scale too. Keywords: Depression, Anxiety, Body dysmorphic, Amputees.

Body dysmorphic disorder in patients with acne: a multicentre study

Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM-IV and DSM-5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6-13.6%). The prevalence was the same with DSM-IV or DSM-5 criteria. Possible cases of BDD were predominantly women (P=0.021), and 56% had non-inflammatory lesions vs. 30% of negative patients (P=0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make-up (72.1%). As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.

Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates

AbstractBackground: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa.Objectives: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates.Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20.Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001).Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings.Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Prevalence of Body Dysmorphic Disorder in Patients Attending Dermatology clinic in Saudi Arabia/Qassim Region

Prevalence of Body Dysmorphic Disorder in Patients Attending Dermatology clinic in Saudi Arabia/Qassim Region

Causeless appearance discontentment in patients of plastic surgeons and cosmetologists: Risk factors and patterns of dynamics

IntroductionThough phenomenon of dysmorphic disorder has been studied extensively clinical dynamical characteristics of this disorder are still being investigated.Aim of this study was to evaluate patterns of dynamics and risk factors of body dysmorphic disorder in patients of plastic surgeons and cosmetologists.MethodsWe included adult patients of Maxillofacial Surgery and Cosmetology departments of Moscow State University of Medicine and Dentistry (from January 2010 to May 2016) with unconfirmed “facial deformity” diagnosed with dysmorphic disorder (F45.2 and F22.88 according to ICD-10). The study used clinical psychopathological method with follow-up period 1–3 years. Data from clinical psychopathological assessment were processed using correlation analysis and non-lineal regression analysis by means of logistic regression method.ResultsStudy sample consisted of 103 patients (78.6% female; mean age 33.4 ± 4.7 years). Statistically significant chronobiological (age, hormone fluctuations, genesial cycle) and psychosocial (financial changes, forced separation, bereavement, loss of job, reduction of social activity, conflict situation, sexual dysfunction, violation of law, diagnosing of somatic disease) risk factors for dysmorphia in different life periods have been established. Strong correlations were found between dysmorphic disorder heterogenic clinical picture (overvalued–33%, affective–24.3%, hypochondric–23.3%, obsessive-compulsive–10.7%, delusional–8.7%) and patterns of dynamics (phasic–41.7%, recurrent–33%, chronic–25.3%). Our data suggest that dysmorphia manifests in any age group and in 74.7% cases is not continuous.ConclusionOur findings allow to conduct focused diagnostic search, prophylactic psychotherapeutic interventions and early psychopharmacological treatment in individuals with identified risk factors for dysmorphic disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence of body dysmorphic disorder in patients who are candidates and/or are submitted to aesthetic procedures in the specialty of plastic surgery: a systematic review with meta-analysis

Prevalence of body dysmorphic disorder in patients who are candidates and/or are submitted to aesthetic procedures in the specialty of plastic surgery: a systematic review with meta-analysis

Body dysmorphic disorder in patients undergoing septorhinoplasty surgery: should we be performing routine screening?

Body dysmorphic disorder (BDD) is defined as having a preoccupation with a perceived flaw in one's appearance, which appears slight to others and significantly interferes with a person's functioning. When undetected in septorhinoplasty patients, it will often lead to poor outcomes. We performed a prospective cohort study to determine the prevalence of BDD in our patients and whether surgical correction could be considered. We recruited 34 patients being considered for septorhinoplasty in a tertiary referral rhinology clinic and a control group of 50 from the otology clinic giving a total of 84. Participants completed the Body Dysmorphic Disorder Questionnaire (BDDQ), the sino-nasal outcome test-23 (SNOT-23) and underwent nasal inspiratory peak flow (NIPF). Those found to be at high risk for BDD were referred to a clinical psychologist. Of the septorhinoplasty patients, 11 (32%) were high risk for BDD. Following psychological assessment, 7 (63%) patients were felt to be unsuitable for surgery and were offered psychological therapy. SNOT-23 scores were significantly higher in the BDD group indicating a negative impact on quality of life. NIPF readings were not significantly different in the BDD group compared to the control group. The BDDQ is a valid tool for identifying patients at risk of BDD. A close working relationship with clinical psychology has been advantageous to help the selection process of candidates for surgery when there is a high risk of BDD.

Body Dysmorphic Disorder in Patients Seeking Abdominoplasty, Rhinoplasty, and Rhytidectomy.

Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. Three hundred patients of both sexes divided into three groups (abdominoplasty, n = 90; rhinoplasty, n =151; and rhytidectomy, n =59) were classified as having (n =51, n =79, and n =25, respectively) or not having (n =39, n =72, and n =34, respectively) body dysmorphic disorder symptoms, based on the Body Dysmorphic Disorder Examination, which was administered preoperatively. Prevalence rates of body dysmorphic disorder symptoms in the abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and 42 percent, respectively. Significant between-group differences were observed regarding age (p < 0.001), body mass index (p = 0.001), and onset of body dysmorphic disorder symptoms (p < 0.001). Within-group differences in body dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001), rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic disorder severity was significantly associated with degree of body dissatisfaction (mean Body Dysmorphic Disorder Examination total scores; p < 0.001), avoidance behaviors (p< 0.001), sexual abuse (p = 0.026), suicidal ideation (p < 0.001), and suicide attempt (p = 0.012). Abdominoplasty candidates showed the highest prevalence; rhytidectomy candidates exhibited the highest percentage of severe cases, and rhinoplasty candidates had the lowest percentage of severe cases.

Body dysmorphic disorder in patients with an eating disorder: Prevalence and characteristics

Body dysmorphic disorder (BDD), an abnormal preoccupation with perceived defects in one or more body parts, and eating disorders (ED) share several essential clinical features, making it sometimes difficult to differentiate between the two disorders. The aims of this study were to assess the prevalence of BDD in patients with ED and to compare characteristics of ED patients with and without BDD. We measured dysmorphic appearance concerns and behaviors, ED symptoms, general psychopathology, and quality of life in 158 patients seeking treatment for ED. Forty-five percent screened positive for BDD. Patients with both disorders (ED + BDD) had significantly more dysmorphic appearance concerns, had more psychopathology, and were dissatisfied with a larger number of body parts than patients with ED only. The differences remained significant even after correcting for severity of eating disorder psychopathology. This finding suggests that BDD is a distinct comorbid disorder in almost half of the patients with ED. It is thus important to recognize and treat the manifestation of BDD in patients with both disorders. Given that the treatment of BDD is different from that of ED, it is important to recognize BDD.