Kisely Stephen, Morkell Daniel, Allbrook Bruce, Briggs Patrick, Jovanovic Jasmina
The Primary Care Mental Health Unit, University of Western Australia, 16 The Terrace, Fremantle, Western Australia 6160, Australia.
Aust N Z J Psychiatry. 2002 Feb;36(1):121-6. doi: 10.1046/j.1440-1614.2002.00981.x.
To compare new referrals to a plastic surgery clinic for cosmetic (non-medically explained) reasons with a control group of equal size with medically explained symptoms.
Patients attending for cosmetic (non-medically explained) reasons were compared with the controls using the general health questionnaire (GHQ), and dysmorphic concern questionnaire (DCQ). Patients were divided into high and low DCQ scores on the basis of their median scores.
Ninety subjects were approached of whom 84 (93%) participated giving 42 patients each in the cosmetic (non-medically explained) and control groups. Forty-four per cent were referred for mammoplasty (n = 37) and 8% for rhinoplasty (n = 7). The other 40 cases (48%) were for other procedures including excision, abdominoplasty and blepharoplasty. Thirty-two per cent of the sample were GHQ cases (n = 27). Patients presenting for cosmetic (non-medically explained) reasons were 13 times more likely to be female (95% CI = 4.3-41), nine times more likely to have high DCQ scores (95% CI = 3.3-24), six times more likely to be GHQ cases (95% CI = 2.1-17), and seven times more likely to present for mammoplasty. The same factors were associated with high DCQ scores. Patients with high DCQ scores were 32 times as likely to be GHQ cases (95% CI = 6.8-151). On multivariate analysis, dysmorphic concern emerged as the only independent predictor of GHQ caseness rather than sex, surgical diagnosis or procedure (adjusted OR = 32.0, 95 % CI = 6.5-156). Similarly, only GHQ caseness and presentation for cosmetic (non-medically explained) surgery independently predicted DCQ score.
Patients presenting for cosmetic (non-medically explained) surgery have high rates of dysmorphic concern and psychiatric morbidity
将因美容（非医学原因）转诊至整形手术诊所的患者与同等规模的有医学解释症状的对照组进行比较。
使用一般健康问卷（GHQ）和畸形担忧问卷（DCQ），将因美容（非医学原因）前来就诊的患者与对照组进行比较。根据患者的中位数得分，将其分为DCQ得分高和低两组。
共接触了90名受试者，其中84名（93%）参与，美容（非医学原因）组和对照组各有42名患者。44%的患者因乳房整形术转诊（n = 37），8%因隆鼻术转诊（n = 7）。其他40例（48%）为其他手术，包括切除术、腹部整形术和眼睑整形术。32%的样本为GHQ病例（n = 27）。因美容（非医学原因）前来就诊的患者女性比例高13倍（95%可信区间 = 4.3 - 41），DCQ得分高的可能性高9倍（95%可信区间 = 3.3 - 24），为GHQ病例的可能性高6倍（95%可信区间 = 2.1 - 17），因乳房整形术前来就诊的可能性高7倍。相同因素与DCQ得分高相关。DCQ得分高的患者为GHQ病例的可能性高32倍（95%可信区间 = 6.8 - 151）。多变量分析显示，畸形担忧是GHQ病例的唯一独立预测因素，而非性别、手术诊断或手术方式（调整后比值比 = 32.0，95%可信区间 = 6.5 - 156）。同样，只有GHQ病例和因美容（非医学原因）手术前来就诊独立预测DCQ得分。
因美容（非医学原因）手术前来就诊的患者存在较高的畸形担忧率和精神疾病发病率
