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

Joseph, J.; Randhawa, Premjit S; Hannan, Swarnali Ahmed; Long, Joseph J.; Goh, Samantha; O'Shea, N.; Saleh, Hesham; Hansen, Esther; Veale, David; Andrews, Peter

doi:10.1111/coa.12752

Cited by 33 publications

(24 citation statements)

References 28 publications

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“…Eighteen studies evaluated cohorts of patients undergoing or seeking surgery (Alavi et al, 2011;Castle et al, 2004;Collins et al, 2014;de Brito et al, 2016a;de Brito et al, 2016b;De Jongh et al, 2009;Dey et al, 2015;Fathololoomi et al, 2013;Hsu et al, 2009;Joseph et al, 2017a;Joseph et al, 2017b;Kacar et al, 2014;Lai et al, 2010;Picavet et al, 2011;Sarwer et al, 1998;Sethukumar et al, 2018;Vulink et al, 2008;Woolley, Perry, 2015).…”

Section: • Cohorts Of Patients Undergoing Surgerymentioning

confidence: 99%

The prevalence of body dysmorphic disorder in the community: a systematic review

Minty¹,

Minty²

2021

GPA

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Objective: Body dysmorphic disorder (BDD) is an underdiagnosed condition among the general population with significant associated morbidity and mortality. Symptoms of BDD include worrying excessively about a particular part of the body, repeatedly checking oneself in the mirror and attempting to cover up particular areas of the body. Aim:To determine the prevalence of BDD within the global population. To perform a further subgroup analysis to identify groups that have a higher prevalence than the general population. To assess the modalities of diagnosis BDD and its relative abundance.Methods: A systematic review using the PubMed database using the search criteria 'BDD' or 'body dysmorphic disorder' and 'prevalence' or 'incidence' from 1 January 1990 to 1 January 2020. 591studies were found, 81 of which were eligible and included in the study. Prevalence was calculated for the global population and subgroups, student, dermatology, surgical and psychiatric patients. Results:The ranges of prevalence within studies were as follows; within the general population, the prevalence of BDD ranged from 0.5-3.2% (n=8). It was 1.3-5.8% (n=8) in student cohorts, 4.9-21.1% (n=12) in general dermatology cohorts, 1.3%-5.8% (n=8) in a student population, 0-54.3% (28) in psychiatric cohorts and 2.9-57% (n=15) in cosmetic surgery cohorts. Conclusion:Studies found had low heterogenicity. However, there was variation in diagnostic criteria and methods of data collection. This study shows that a significant number of people suffer from BDD. Due to the fact that people with BDD often don't seek help, this number is likely an underestimation. This study identified subgroups of the population that have a higher prevalence of BDD. Targeted screening of individuals in high-risk cohorts, as well as further clinician education, may be of benefit to help aid early recognition and diagnosis. Additionally, structured clinical interviews for DSM (the Diagnostic and Statistical Manual of Mental Disorders), also known as SCID, were the most common and appear to be more effective than normal interviews at identifying individuals with BDD.

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Section: • Cohorts Of Patients Undergoing Surgerymentioning

confidence: 99%

The prevalence of body dysmorphic disorder in the community: a systematic review

Minty¹,

Minty²

2021

GPA

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“…The participants of that study were divided into the mild-to-moderate (n = 39), without symptoms (n = 81), and severe BDD (n = 11) groups based on their Body Dysmorphic Disorder Examination scores, with estimated total mean scores of 89.02, 32.90, and 114.90, respectively. In the United Kingdom, Joseph et al 29 also reported that the prevalence of BDD among septorhinoplasty candidates was high, indicating an urgent need for adequate screening modalities for better prevention and management. They also reported that gender plays a significant role in the prevalence of BDD, with prevalence rates of 45% and 26% when rates were separately estimated for women and men, respectively.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Body Dysmorphic Disorder Among Rhinoplasty Candidates: A Systematic Review

et al. 2021

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Objective Body dysmorphic disorder (BDD) represents a bridge between the fields of psychiatry and cosmetic surgery. It is a psychiatric disorder involving altered body image and has been associated with cosmetic surgery. Many studies have investigated BDD following rhinoplasty. However, their findings were inconsistent, which prompted us to conduct this systematic review to obtain strong evidence about the prevalence of BDD among rhinoplasty candidates. Methods We searched the literature using electronic databases such as PubMed, Scopus, Web of Science, and others using keywords relevant to the study outcomes. We also manually examined the references of the included studies and relevant reviews to look for articles that might have been missed during the electronic search. Results Nine articles met the inclusion criteria. We identified 7 other relevant articles; since they had been included in a review conducted in 2016, they were not included in the final list of articles. However, they were included in the discussion, and their findings have been compared with ours. The included articles resulted in a total sample of 712 rhinoplasty candidates. The estimated prevalence rates of BDD in these articles ranged from 22% to 52%, which was considered high by all the authors of the included studies. Conclusion The prevalence of BDD among rhinoplasty candidates is high, and adequate management and interventions are needed to reduce it.

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“…68,69 It has been reported that patients with nasal obstruction report a higher risk of depression 70 and anxiety. 71 Joseph et al report that of those patients attending for SRP consultations up to 32% are at risk of body dysmorphic disorder (BDD) 72 compared with a BDD prevalence of just 2% in the general population. 73 Ercolani et al report that for the majority of patients undergoing SRP surgery particularly for medical or cosmetic reasons, there is a significant reduction in anxiety scores post-surgery.…”

Section: The Importance Of Psychology In Functional Septorhinoplasty mentioning

confidence: 99%

“…The use of screening questionnaires, as adopted by Joseph et al, is a useful starting point. 72 If individuals are identified as high risk, it is prudent that a thorough psychological assessment is performed by a clinical psychologist/psychiatrist and appropriate treatment provided if necessary.…”

Section: The Importance Of Psychology In Functional Septorhinoplasty Surgerymentioning

confidence: 99%

The Evidence Base for the Benefits of Functional Septorhinoplasty and its Future Post COVID-19

et al. 2021

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Ever since the introduction of the concept of Procedures of Limited Clinical Value (PoLCV), procedures such as functional septorhinoplasty have been subject to additional funding restrictions within the British National Health Service. Recent publications have suggested that 10% of Clinical Commissioning Groups in the United Kingdom no longer fund septorhinoplasty surgery irrespective of the indications, including congenital malformations or post-trauma, and despite the strong evidence available in the literature in treating a range of health conditions. Thus, inequity exists across the country. At present functional septorhinoplasty surgery is frequently but incorrectly grouped together with aesthetic rhinoplasty, both of which are deemed to be cosmetic interventions. Moreover, as we exit the peak of the current coronavirus disease 2019 (COVID-19) pandemic, procedures deemed to be of lower clinical priority will potentially be at risk throughout Europe. The purpose of this review is twofold; the first is to put forward the evidence to commissioners in favor of functional septorhinoplasty surgery on patient well-being and mental health; the second is to demonstrate why functional septorhinoplasty surgery is a distinct procedure from aesthetic rhinoplasty and why it ought not to be classified as a procedure of limited clinical value.

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

Abstract: Running Title: This is a prospective cohort study using the validated body dysmorphic disorder questionnaire to screen for the prevalence of this condition in septorhinoplasty patients. We provide a model for their management discuss the benefits of operating on such patients.

Cited by 33 publications

References 28 publications

The prevalence of body dysmorphic disorder in the community: a systematic review

The prevalence of body dysmorphic disorder in the community: a systematic review

Prevalence of Body Dysmorphic Disorder Among Rhinoplasty Candidates: A Systematic Review

The Evidence Base for the Benefits of Functional Septorhinoplasty and its Future Post COVID-19

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