Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK.
J Cosmet Dermatol. 2023 Jul;22(7):1951-1966. doi: 10.1111/jocd.15685. Epub 2023 Feb 27.
Body dysmorphic disorder (BDD) is a psychiatric disturbance with high incidence in aesthetic clinical settings. Early recognition may avoid unnecessary elective procedures with ethical and medicolegal consequences.
To identify validated BDD screening tools and critically appraise current literature regarding its implementation and efficacy in aesthetic medicine and surgery scenarios, with the purpose of transposing the findings to the broad clinical settings in the field.
Data was collected using advanced search from PubMed (MEDLINE). Having satisfied the search parameters, 12 studies referring BDD definition according to Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria and including a BDD screening tool in clinical aesthetic settings were selected.
While BDD screening enables the recognition of at-risk individuals, further work is required to uncover the best screening tool for general aesthetic clinical practice. Level III evidence favored BDD Questionnaire (BDDQ)/BDDQ-Dermatology Version (DV), and The Dysmorphic Concern Questionnaire (DCQ) among the limited available validated screening instruments to be used outside the psychiatric environment. Based on level II self-classification, one study selected BDDQ-Aesthetic Surgery (AS) version for rhinoplasty patients. The validation process of both BDDQ-AS and Cosmetic Procedure Screening Questionnaire (COPS) had limitations. For BDD screening potential in avoiding postoperative complications, the limited studies found evaluating the outcomes following aesthetic treatments using validated BDD screening measures showed a trend toward less satisfaction with aesthetic treatment outcome among positive screening population against non-BDD counterparts.
Further research is necessary to establish more effective methods to identify BDD and evaluate the impact of positive findings on aesthetic intervention outcomes. Future studies may elucidate which BDD characteristics best predict a favorable outcome and provide high-quality evidence for standardized protocols in research and clinical practice.
躯体变形障碍（BDD）是一种在美学临床环境中发病率较高的精神障碍。早期识别可能避免因伦理和法医学原因而进行不必要的选择性手术。
确定经过验证的 BDD 筛查工具，并批判性地评估当前文献，了解其在美容医学和外科领域的实施和疗效，以便将研究结果推广到该领域广泛的临床环境中。
使用高级搜索从 PubMed（MEDLINE）中收集数据。在满足搜索参数后，选择了 12 项研究，这些研究根据《精神障碍诊断与统计手册》（DSM-5）标准定义 BDD，并在临床美学环境中包含 BDD 筛查工具。
虽然 BDD 筛查可以识别处于风险中的个体，但仍需要进一步研究以发现最适合一般美学临床实践的筛查工具。三级证据支持 BDD 问卷（BDDQ）/BDDQ-皮肤病学版本（DV）和畸形关注问卷（DCQ）作为有限的已验证的筛查工具，可在精神病学环境之外使用。基于二级自我分类，一项研究选择了用于鼻整形术患者的 BDDQ-美容外科（AS）版本。BDDQ-AS 和美容程序筛查问卷（COPS）的验证过程都存在局限性。对于 BDD 筛查在避免术后并发症方面的潜力，有限的研究发现，使用经过验证的 BDD 筛查措施评估美学治疗后的结果表明，在阳性筛查人群中，对美学治疗结果的满意度低于非 BDD 对照组。
需要进一步研究以建立更有效的方法来识别 BDD，并评估阳性发现对美学干预结果的影响。未来的研究可能会阐明哪些 BDD 特征最能预测良好的结果，并为研究和临床实践中的标准化方案提供高质量的证据。
