Dons Flore, Mulier Delphine, Maleux Olivia, Shaheen Eman, Politis Constantinus
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven, Leuven, Belgium.
J Stomatol Oral Maxillofac Surg. 2022 Sep;123(4):e145-e152. doi: 10.1016/j.jormas.2021.10.015. Epub 2021 Oct 30.
General prevalence of Body Dysmorphic Disorder (BDD), a psychiatric disorder in which patients focus on an imagined body defect not visible to others, varies between 0.7 and 2.5%. Up to 86% present with complaints in the area of teeth or face. Patients with BDD pursue an aesthetic rather than functional recovery, making BDD a possible contraindication to treatment. The aim of this systematic review was to review prevalence of BDD within the orthodontic and/or orthognathic population, to describe diagnostic tools for early detection of patients with BDD and to assess the outcome after treatment. A systematic search was conducted up to November 2020 using PubMed, Embase, Web of Science Core Collection and Cochrane Library. Following the screening of 1423 articles, 5 prospective studies were included. Prevalence of BDD within the orthodontic and orthognathic population varied from 5.2% to 13% (average of 6.2%). Literature showed a trend of higher BDD prevalence within younger, female and single patient population, although results are not conclusive. Questionnaires can be useful for preliminary detection of BDD. General anamnesis with questioning medical or psychiatric history, medication and personal expectations remains very important. Red flags could be previous consultations for the same problem or presence of psychiatric comorbidities. Prospective studies are necessary to map satisfaction of these patients and need for re-interventions after treatment.
躯体变形障碍（BDD）是一种精神疾病，患者专注于他人看不见的想象中的身体缺陷，其总体患病率在0.7%至2.5%之间。高达86%的患者在牙齿或面部区域有相关主诉。BDD患者追求的是美学而非功能恢复，这使得BDD可能成为治疗的禁忌证。本系统评价的目的是回顾正畸和/或正颌人群中BDD的患病率，描述早期发现BDD患者的诊断工具，并评估治疗后的结果。截至2020年11月，使用PubMed、Embase、科学引文索引核心合集和考克兰图书馆进行了系统检索。在筛选了1423篇文章后，纳入了5项前瞻性研究。正畸和正颌人群中BDD的患病率在5.2%至13%之间（平均为6.2%）。文献显示，在年轻、女性和单身患者群体中，BDD患病率有升高趋势，尽管结果尚无定论。问卷调查有助于BDD的初步检测。询问病史、用药情况和个人期望的全面问诊仍然非常重要。危险信号可能是此前因同一问题进行过咨询或存在精神疾病共病情况。有必要进行前瞻性研究，以了解这些患者的满意度以及治疗后再次干预的需求。
