Ramos Tatiana Dalpasquale, de Brito Maria José Azevedo, Suzuki Vanessa Yuri, Sabino Neto Miguel, Ferreira Lydia Masako
Graduate Program in Translational Surgery, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil.
Division of Plastic Surgery, Department of Surgery, UNIFESP, Rua Botucatu 740, 2o. andar, São Paulo, São Paulo, CEP 04023-062, Brazil.
Aesthetic Plast Surg. 2019 Aug;43(4):1000-1005. doi: 10.1007/s00266-018-1300-1. Epub 2019 Jan 3.
Rhinoplasty is one of the most sought-after procedures in plastic surgery by individuals with body dysmorphic disorder (BDD). The identification of BDD symptoms is a challenge for plastic surgeons. The purpose of this study was to use a specific instrument for detection of BDD symptoms as a screening tool in rhinoplasty candidates and estimate the prevalence and severity of BDD symptoms in this population.
Eighty patients of both sexes seeking rhinoplasty were consecutively recruited at a plastic surgery outpatient clinic of a university hospital from February 2014 to March 2015. In a clinical interview, 50 of them showed an excessive preoccupation with physical appearance associated with clinically significant subjective distress and were, therefore, selected to participate in the study. All participants were assessed using the Brazilian-Portuguese versions of the Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD-YBOCS) and the Body Dysmorphic Symptoms Scale (BDSS), which can be applied by plastic surgeons, who are laypersons in psychology/psychiatry.
Twenty-four (48%, 24/50) candidates had BDD symptoms, and 27 (54%, 27/50) showed moderate to severe appearance-related obsessive-compulsive symptoms. A strong correlation was found between the BDSS and BDD-YBOCS scores (r = 0.841, P < 0.001), and a strong agreement was observed between the BDSS cutoff point and body dysmorphic disorder symptom status (kappa = 0.822).
A high prevalence of BDD and moderate to severe appearance-related obsessive-compulsive symptoms was found among aesthetic rhinoplasty candidates. The BDSS may be used as a screening tool for BDD symptoms in plastic surgery patients.
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隆鼻手术是身体变形障碍（BDD）患者在整形手术中最常寻求的手术之一。识别BDD症状对整形外科医生来说是一项挑战。本研究的目的是使用一种检测BDD症状的特定工具作为隆鼻手术候选者的筛查工具，并评估该人群中BDD症状的患病率和严重程度。
2014年2月至2015年3月，在一家大学医院的整形外科门诊连续招募了80名寻求隆鼻手术的患者。在临床访谈中，其中50人表现出对身体外观的过度关注，并伴有临床上显著的主观痛苦，因此被选入研究。所有参与者均使用巴西葡萄牙语版的针对BDD修改的耶鲁-布朗强迫量表（BDD-YBOCS）和身体变形症状量表（BDSS）进行评估，这些量表可由整形外科医生（他们并非心理学/精神病学专业人员）应用。
24名（48%，24/50）候选者有BDD症状，27名（54%，27/50）表现出中度至重度的外貌相关强迫症状。BDSS和BDD-YBOCS评分之间存在强相关性（r = 0.841，P < 0.001），并且在BDSS截断点和身体变形障碍症状状态之间观察到高度一致性（kappa = 0.822）。
在美容隆鼻手术候选者中发现BDD的高患病率以及中度至重度的外貌相关强迫症状。BDSS可作为整形外科患者BDD症状的筛查工具。
证据水平IV：本期刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
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