Prevalence of Body Dysmorphic Disorder and Impact on Subjective Outcome amongst Singaporean Rhinoplasty Patients

Jeremy, Goh Chin Guan

doi:10.4172/2161-1173.1000140

Cited by 6 publications

(12 citation statements)

References 17 publications

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“…These findings contrast to anecdotal beliefs that those with worse mental health are less likely to be satisfied or gain benefit from rhinoplasty . Comparing our findings with those in the existing rhinoplasty literature is challenging, as there are multiple methods of gauging satisfaction, each with strengths and limitations, that produce different cohorts of satisfied and unsatisfied patients . For instance, studies allowed satisfaction to be interpreted by the patient to include appearance, function, and general level of care; had limited evaluations of function; were retrospective or cross-sectional and thus subject to recall bias; or were not validated .…”

Section: Discussioncontrasting

confidence: 70%

“…1,24 Comparing our findings with those in the existing rhinoplasty literature is challenging, as there are multiple methods of gauging satisfaction, each with strengths and limitations, that produce different cohorts of satisfied and unsatisfied patients. 8,24,32,49,50 For instance, studies allowed satisfaction to be interpreted by the patient to include appearance, function, and general level of care; had limited evaluations of function 32,50 ; were retrospective or cross-sectional 6,8,50,51 and thus subject to recall bias 48 ; or were not validated. 24 Clearly, research in rhinoplasty would benefit from a more standardized and rigorous approach to gauging satisfaction.…”

Section: Discussionmentioning

confidence: 99%

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Association Between Mental Health Status and Patient Satisfaction With the Functional Outcomes of Rhinoplasty

Strazdins

Nie

Ramli

et al. 2018

JAMA Facial Plast Surg

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IMPORTANCE Mental health can have an impact on patient satisfaction with rhinoplasty. However, the association between mental health and patient satisfaction with functional outcomes of rhinoplasty is poorly understood. OBJECTIVE To determine whether preoperative mental health is associated with satisfaction with functional outcomes of rhinoplasty. DESIGN, SETTING, AND PARTICIPANTS This case-control study assessed baseline nasal function and postsurgical functional outcomes for 88 consecutive patients undergoing rhinoplasty with both cosmetic and functional goals at 2 tertiary rhinologic centers in Sydney, Australia. EXPOSURES Poor mental well-being was defined preoperatively by the Optum SF-36v2 Health Survey mental component summary. MAIN OUTCOMES AND MEASURES Nasal function was assessed with patient-reported outcome measures, including visual analog scales, the Nasal Obstruction Symptom Evaluation Scale (NOSE), the 22-item Sinonasal Outcome Test (SNOT-22), and Likert scales. Objective outcomes included nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area. All outcomes were assessed preoperatively and 6 months postoperatively. The 36-item Optum SF-36v2 Health Survey mental component summary was used to assess mental well-being, with a score of less than 40 indicating poor mental well-being and a score 40 or higher indicating normal well-being. RESULTS Mean (SD) patient age was 37.6 (12.9) years and 53 of 88 (60.2%) were women. The mental component summary defined impaired well-being in n = 24 (cases) and normal well-being in n = 64 (controls). There were improvements in the total study population across most nasal function outcomes and in both groups. After rhinoplasty, benefit was seen for both groups in visual analog scale (left side mean [SD] change, 18 [30]; P < .001 and right side mean [SD] change, 24 [30]; P < .001); NOSE (mean [SD] change, 1.35 [1.21]; P < .001); and SNOT-22 (mean [SD] change, 0.81 [0.88]; P < .001) scores. Nasal peak inspiratory flow improved for both groups (mean [SD] change, 32 [45] L/min; P < .001), while nasal airway resistance and minimum cross-sectional area remained similar (change in nasal airway resistance, 0.086 Pa/cm 3 /s; 95% CI, −0.007 Pa/cm 3 /s to 0.179 Pa/cm 3 /s and change in minimum cross-sectional area, −0.04 cm 2 ; 95% CI, −0.21 cm 2 to 0.13 cm 2). Patients with poor mental health had similar improvements in nasal function compared with controls. CONCLUSIONS AND RELEVANCE Rhinoplasty imparts similar benefits to nasal function assessed by patient-reported outcome measures and objective airflow measures regardless of preoperative mental health status. LEVEL OF EVIDENCE 3.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Association Between Mental Health Status and Patient Satisfaction With the Functional Outcomes of Rhinoplasty

Strazdins

Nie

Ramli

et al. 2018

JAMA Facial Plast Surg

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“…Patients with poor mental well-being perceived their nasal function as significantly poorer in all patient-reported outcome measures (Table 1). Specifically, those with poor mental health had significantly poorer mean (SD) scores than patients with good mental health in the sensation of nasal obstruction using the VAS for the left side (51 [25] vs 42 [25]; P = .001), VAS for the right side (54 [24] vs 45 [26] with good mental health (Table 1). While mean (SD) NPIF was significantly different between the groups (107 [42] L/min in those with poor mental well-being vs 119 [45] L/min in those with good mental health; P = .006), this difference was less than the minimum clinically important difference of 20 L/min.…”

Section: Mental Well-being and Baseline Perception Of Nasal Functionmentioning

confidence: 99%

“…4 More important, rhinoplasty is the most common surgical procedure for patients with BDD. 4,[20][21][22] Although BDD has an estimated prevalence of 0.5% to 3% of the population, 23 patients undergoing cosmetic rhinoplasty have a disproportionate prevalence of the disorder, with estimates ranging from 2% to 15% 3,23,24 and more than 30% in some studies. 17,25 Furthermore, while not meeting the full diagnostic criteria of BDD, researchers have noted that 40% to 70% of patients undergoing rhinoplasty have greater dysmorphic concerns than seen in the general population.…”

mentioning

confidence: 99%

Association of Mental Health Status With Perception of Nasal Function

Strazdins

Nie

Ramli

et al. 2017

JAMA Facial Plast Surg

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IMPORTANCE Mental health issues are thought to be overrepresented among patients undergoing rhinoplasty and may be associated with patient presentation prior to surgery.OBJECTIVE To assess the association of poor mental health with perception of nasal function. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study of patients presenting for airway assessment was performed from December 1, 2011, to October 31, 2015, at 2 tertiary rhinoplasty centers in Sydney, Australia. Mental health was independently defined preoperatively by the Mental Component Summary of the 36-item Short Form Health Survey version 2 (a score of <40 indicated poor mental well-being), the Rosenberg Self-Esteem Scale (a score of <15 indicated low self-esteem), and the Dysmorphic Concerns Questionnaire (a score of >11 indicated above-average dysmorphic concerns). MAIN OUTCOMES AND MEASURESNasal function was assessed with patient-reported outcome measures, including the Nasal Obstruction Symptom Evaluation Scale, the 22-item Sinonasal Outcome Test, a visual analog scale to rate ease of breathing on the left and right sides, and Likert scales to assess overall function and nasal obstruction. Nasal airflow was assessed by nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area.RESULTS Among 495 patients in the study (302 women and 193 men; mean [SD] age, 36.5 [13.6] years), compared with patients with good mental health, those with poor mental health had poorer scores in all patient-reported outcome measures, including the visual analog scale for the left side (mean [SD], 51 [25] vs 42 [25]; P = .001), visual analog scale for the right side (mean [SD], 54 [24] vs 45 [26]; P < .001), Nasal Obstruction Symptom Evaluation Scale (mean [SD], 2.64 [0.95] vs 1.96 [1.04]; P < .001), 22-item Sinonasal Outcome Test (mean [SD], 2.14 [0.84] vs 1.33 [0.83]; P < .001), nasal obstruction (58 of 145 [40.2%] vs 83 of 350 [23.7%] with severe or worse obstruction; P < .001), and nasal function (72 of 145 [49.7%] vs 111 of 350 [31.8%] with poor or worse function; P < .001). Subclinical differences in nasal peak inspiratory flow could be demonstrated, but all other nasal airflow measures were similar. Low self-esteem produced a similar pattern, but dysmorphia did not. CONCLUSIONS AND RELEVANCEPoor mental health status is associated with a poorer self-perception of nasal function compared with those who are mentally healthy with clinically similar nasal airflow. Clinicians should be aware that patients with poor mental health reporting obstructed airflow may in part be representing an extension of their negative emotions rather than true obstruction and may require further assessment prior to surgery.LEVEL OF EVIDENCE NA.

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“…However, the results coming from the researchers in Singapore hospitals show that BDD is quite prevalent among patients who have received cosmetic rhinoplasty. BDD patients are likely to have poorer subjective outcomes after surgery although they may experience some improvement in satisfaction when compared to before surgery [48].…”

Section: Cultural Factorsmentioning

confidence: 99%

A Distorted Body Image: Cognitive Behavioral Therapy for Body Dysmorphic Disorder

Ayub¹,

Kimong²,

Ee³

2020

Cognitive Behavioral Therapy - Theories and Applications

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Body dysmorphic disorder (BDD) is one of the mental disorders that warrant more research due to the current challenges and complexity of human life. A search through Medline, Academic Search Premier, PsycINFO, and PsyArticles, using "body dysmorphic disorder" and "intervention" keywords, showed that a total of 186 articles had been published for the past 25 years. BDD was added to the obsessive-compulsive and related disorder spectrum in the Diagnostic and Statistical Manual of Mental Disorder-5 (2013). BDD is a preoccupation with an imagined defect in physical appearance by individual who looks normal which causes low self-esteem and co-morbids with other mental health problems. Individuals with BDD often end up with dermatological treatment and cosmetic surgery. However, in most cases, they frequently experience a dissatisfaction with the results and worsen the individual condition. Therefore, psychological intervention is needed to treat individuals with BDD to combat their negative perceptions on physical appearance. Research has shown that one of the effective interventions in treating individuals with BDD is cognitive behavioral therapy (CBT). Some techniques that are recommended are psychoeducation, restructuring cognitive, exposure and ritual prevention, and others. This paper aims to discuss the clinical diagnosis and CBT intervention as a treatment for individual with BDD.

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Prevalence of Body Dysmorphic Disorder and Impact on Subjective Outcome amongst Singaporean Rhinoplasty Patients

Cited by 6 publications

References 17 publications

Association Between Mental Health Status and Patient Satisfaction With the Functional Outcomes of Rhinoplasty

Association Between Mental Health Status and Patient Satisfaction With the Functional Outcomes of Rhinoplasty

Association of Mental Health Status With Perception of Nasal Function

A Distorted Body Image: Cognitive Behavioral Therapy for Body Dysmorphic Disorder

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