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Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis

Abstract

The aim of the present study was to evaluate the prevalence of body dysmorphic disorder in plastic surgery and dermatology patients, by performing a systematic review of the literature and meta-analysis. The most relevant studies published originally in any language were analyzed. The literature search was performed using the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scielo databases. The final sample comprised 33 publications that were submitted to meta-analysis. The study verified that 15.04% of plastic surgery patients had body dysmorphic disorder (range 2.21–56.67%); patient mean age was 34.54 ± 12.41 years, and most were women (74.38%). Among dermatology patients, 12.65% (range 4.52–35.16%) had body dysmorphic disorder; patient mean age was 27.79 ± 9.03 years, and most were women (76.09%). Both plastic surgeons and dermatologists must adequately assess their patients to identify those with a higher likelihood of body dysmorphic disorder and should arrange multidisciplinary care for such individuals.

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References

  1. Conrado LA, Hounie AG, Diniz JB, Fossaluza V, Torres AR, Miguel EC, Rivitti EA (2010) Body dysmorphic disorder among dermatologic patients: prevalence and clinical features. J Am Acad Dermatol 63:235–243

    Article  PubMed  Google Scholar 

  2. Bjornsson AS, Didie ER, Phillips KA (2010) Body dysmorphic disorder. Dialogues Clin Neurosci 12:221–232

    PubMed  PubMed Central  Google Scholar 

  3. Felix GA, Brito MJ, Nahas FX, Tavares H, Cordas TA, Dini GM, Ferreira LM (2014) Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty. J Plast Reconstr Aesthet Surg 67:646–654

    Article  PubMed  Google Scholar 

  4. Veale D (2004) Body dysmorphic disorder. Postgrad Med J 80:67–71

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  5. American Psychiatric Association APA (2013) Obsessive-compulsive and related disorders. Diagnostic and statistical manual of mental disorders, 5th edn. APA, Arlington

    Book  Google Scholar 

  6. Phillips K (1996) The broken mirror: understanding and treating body dysmorphic disorder. Oxford University Press, New York

    Google Scholar 

  7. Veale D, Gledhill LJ, Christodoulou P, Hodsoll J (2016) Body dysmorphic disorder in different settings: a systematic review and estimated weighted prevalence. Body Image 18:168–186

    Article  PubMed  Google Scholar 

  8. Vulink NCC, Sigurdsson V, Kon M, Bruijnzeel-Koomen CAFM, Westenberg HGM, Denys D (2006) Stoornis in de lichaamsbeleving bij 3–8% van de patiënten op de poliklinieken Dermatologie en Plastische Chirurgie. Ned Tijdschr Geneeskd 150:97–100

    CAS  PubMed  Google Scholar 

  9. Ishigooka J, Iwao M, Suzuki M, Fukuyama Y, Murasaki M, Miura S (1998) Demographic features of patients seeking cosmetic surgery. Psychiatry Clin Neurosci 52:283–287

    CAS  Article  PubMed  Google Scholar 

  10. Sarwer DB, Wadden TA, Pertschuk MJ, Whitaker LA (1998) Body image dissatisfaction and body dysmorphic disorder in 100 cosmetic surgery patients. Plast Reconstr Surg 101:1644–1649

    CAS  Article  PubMed  Google Scholar 

  11. Altamura C, Paluello MM, Mundo E, Medda S, Mannu P (2001) Clinical and subclinical body dysmorphic disorder. Eur Arch Psychiatry Clin Neurosci 251:105–108

    CAS  Article  PubMed  Google Scholar 

  12. Vargel S, Ulusahin A (2001) Psychopathology and body image in cosmetic surgery patients. Aesthetic Plast Surg 25:474–478

    CAS  Article  PubMed  Google Scholar 

  13. Vindigni V, Pavan C, Semenzin M, Granà S, Gambaro FM, Marini M, Mazzoleni F (2002) The importance of recognizing body dysmorphic disorder in cosmetic surgery patients: do our patients need a preoperative psychiatric evaluation? Eur J Plast Surg 25:305–308

    Article  Google Scholar 

  14. Aouizerate B, Pujol H, Grabot D, Faytout M, Suire K, Braud C, Auriacombe M, Martin D, Baudet J, Tignol J (2003) Body dysmorphic disorder in a sample of cosmetic surgery applicants. Eur Psychiatry 18:365–368

    CAS  Article  PubMed  Google Scholar 

  15. Crerand CE (2003) Rate of body dysmorphic disorder among patients seeking facial cosmetic procedures. Doctoral Thesis, Drexel University, Philadelphia

  16. Castle DJ, Molton M, Hoffman K, Preston NJ, Phillips KA (2004) Correlates of dysmorphic concern in people seeking cosmetic enhancement. Aust N Z J Psychiatry 38:439–444

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bellino S, Zizza M, Paradiso E, Rivarossa A, Fulcheri M, Bogetto F (2006) Dysmorphic concern symptoms and personality disorders: a clinical investigation in patients seeking cosmetic surgery. Psychiatry Res 144:73–78

    Article  PubMed  Google Scholar 

  18. Hayashi K, Miyachi H, Nakakita N, Akimoto M, Aoyagi K, Miyaoka H, Uchinuma E (2007) Importance of a psychiatric approach in cosmetic surgery. Aesthet Surg J 27:396–401

    CAS  Article  PubMed  Google Scholar 

  19. Lai CS, Lee SS, Yeh YC, Chen CS (2010) Body dysmorphic disorder in patients with cosmetic surgery. Kaohsiung J Med Sci 26:478–482

    Article  PubMed  Google Scholar 

  20. Alavi M, Kalafi Y, Dehbozorgi GR, Javadpour A (2011) Body dysmorphic disorder and other psychiatric morbidity in aesthetic rhinoplasty candidates. J Plast Reconstr Aesthet Surg 64:738–741

    Article  PubMed  Google Scholar 

  21. Picavet VA, Prokopakis EP, Gabriels L, Jorissen M, Hellings PW (2011) High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty. Plast Reconstr Surg 128:509–517

    CAS  Article  PubMed  Google Scholar 

  22. Fathololoomi MR, Goljanian Tabrizi A, Fattahi Bafghi A, Noohi SA, Makhdoom A (2013) Body dysmorphic disorder in aesthetic rhinoplasty candidates. Pak J Med Sci 29:197–200

    Google Scholar 

  23. Jeremy GCG, Stephen L (2014) Prevalence of body dysmorphic disorder and impact on subjective outcome amongst Singaporean rhinoplasty patients. Anaplastology 3:140

    Google Scholar 

  24. Metcalfe DB, Duggal CS, Gabriel A, Nahabedian MY, Carlson GW, Losken A (2014) Prevalence of body dysmorphic disorder among patients seeking breast reconstruction. Aesthet Surg J 34:733–737

    Article  PubMed  Google Scholar 

  25. Dey JK, Ishii M, Phillis M, Byrne PJ, Boahene KD, Ishii LE (2015) Body dysmorphic disorder in a facial plastic and reconstructive surgery clinic: measuring prevalence, assessing comorbidities, and validating a feasible screening instrument. JAMA Facial Plast Surg 17:137–143

    Article  PubMed  Google Scholar 

  26. Woolley AJ, Perry JD (2015) Body dysmorphic disorder: prevalence and outcomes in an oculofacial plastic surgery practice. Am J Ophthalmol 159(1058–1064):e1051

    Google Scholar 

  27. Brito MJ, Nahas FX, Cordas TA, Tavares H, Ferreira LM (2016) Body dsmorphic disorder in patients seeking abdominoplasty, rhinoplasty, and rhytidectomy. Plast Reconstr Surg 137:462–471

    Article  PubMed  Google Scholar 

  28. Brito MJ, Nahas FX, Cordas TA, Gama MG, Sucupira ER, Ramos TD, Felix Gde A, Ferreira LM (2016) Prevalence of body dysmorphic disorder symptoms and body weight concerns in patients seeking abdominoplasty. Aesthet Surg J 36:324–332

    Article  PubMed  PubMed Central  Google Scholar 

  29. Phillips KA, Dufresne RG Jr, Wilkel CS, Vittorio CC (2000) Rate of body dysmorphic disorder in dermatology patients. J Am Acad Dermatol 42:436–441

    CAS  Article  PubMed  Google Scholar 

  30. Uzun O, Basoglu C, Akar A, Cansever A, Ozsahin A, Cetin M, Ebrinc S (2003) Body dysmorphic disorder in patients with acne. Compr Psychiatry 44:415–419

    Article  PubMed  Google Scholar 

  31. Bowe WP, Leyden JJ, Crerand CE, Sarwer DB, Margolis DJ (2007) Body dysmorphic disorder symptoms among patients with acne vulgaris. J Am Acad Dermatol 57:222–230

    Article  PubMed  Google Scholar 

  32. Hsu C, Ali Juma H, Goh CL (2009) Prevalence of body dysmorphic features in patients undergoing cosmetic procedures at the National Skin Centre, Singapore. Dermatology 219:295–298

    CAS  Article  PubMed  Google Scholar 

  33. Kacar SD, Ozuguz P, Bagcioglu E, Coskun KS, Uzel Tas H, Polat S, Karaca S (2014) The frequency of body dysmorphic disorder in dermatology and cosmetic dermatology clinics: a study from Turkey. Clin Exp Dermatol 39:433–438

    Article  Google Scholar 

  34. Kacar SD, Ozuguz P, Bagcioglu E, Coskun KS, Polat S, Karaca S, Ozbulut O (2016) Frequency of body dysmorphic disorder among patients with complaints of hair loss. Int J Dermatol 55:425–429

    Article  Google Scholar 

  35. Thanveer F, Khunger N (2016) Screening for body dysmorphic disorder in a dermatology outpatient setting at a Tertiary Care Centre. J Cutan Aesthet Surg 9:188–191

    Article  PubMed  PubMed Central  Google Scholar 

  36. Buhlmann U, Glaesmer H, Mewes R, Fama JM, Wilhelm S, Brahler E, Rief W (2010) Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Res 178:171–175

    Article  PubMed  Google Scholar 

  37. Koran LM, Abujaoude E, Large MD, Serpe RT (2008) The prevalence of body dysmorphic disorder in the United States adult population. CNS Spectr 13:316–322

    Article  PubMed  Google Scholar 

  38. Otto MW, Wilhelm S, Cohen LS, Harlow BL (2001) Prevalence of body dysmorphic disorder in a community sample of women. Am J Psychiatry 158:2061–2063

    CAS  Article  PubMed  Google Scholar 

  39. Rief W, Buhlmann U, Wilhelm S, Borkenhagen A, Brahler E (2006) The prevalence of body dysmorphic disorder: a population-based survey. Psychol Med 36:877–885

    Article  PubMed  Google Scholar 

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Correspondence to Rafael Vilela Eiras Ribeiro.

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Ribeiro, R.V.E. Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis. Aesth Plast Surg 41, 964–970 (2017). https://doi.org/10.1007/s00266-017-0869-0

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  • DOI: https://doi.org/10.1007/s00266-017-0869-0

Keywords

  • Plastic surgery
  • Dermatology
  • Body dysmorphic disorder
  • Prevalence