Türk Cemre Büşra, Maymone Mayra B C, Kroumpouzos George
Department of Dermatology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Clin Dermatol. 2023 Jan-Feb;41(1):16-27. doi: 10.1016/j.clindermatol.2023.03.001. Epub 2023 Mar 5.
Body dysmorphic disorder (BDD) is a psychiatric condition characterized by profound concern about a minor or imagined defect in the appearance of individuals and increased preoccupation with the imagined/perceived defect. Individuals with BDD often undergo cosmetic intervention for the perceived imperfection but rarely experience improvement in their signs and symptoms after such treatment. It is recommended that aesthetic providers evaluate individuals face-to-face and screen for BDD with approved scales preoperatively to determine the candidate's suitability for the procedure. This contribution focuses on diagnostic and screening tools and measures of disease severity and insight that providers working in nonpsychiatric settings can use. Several screening tools were explicitly developed for BDD; others were designed to evaluate body image/dysmorphic concern. The BDD Questionnaire (BDDQ)-Dermatology Version (BDDQ-DV), BDDQ-Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), and Body Dysmorphic Symptom Scale (BDSS) have been developed explicitly for BDD and validated in cosmetic settings. The limitations of screening tools are discussed. Given the increasing use of social media, future revisions of BDD instruments should consider incorporating questions relevant to patients' behaviors on social media. Current screening tools can adequately test for BDD despite their limitations and a need for updates.
躯体变形障碍（BDD）是一种精神疾病，其特征是对自身外貌上的微小或想象中的缺陷深感担忧，并对这种想象或感知到的缺陷愈发关注。患有BDD的个体常常会因察觉到的不完美而接受美容干预，但这种治疗后他们的体征和症状很少会有所改善。建议美容服务提供者在术前对个体进行面对面评估，并使用经批准的量表筛查BDD，以确定该候选人是否适合手术。本文着重介绍非精神科环境下的从业者可使用的诊断和筛查工具以及疾病严重程度和自知力的测量方法。有几种筛查工具是专门为BDD开发的；其他一些则旨在评估身体意象/变形担忧。BDD问卷（BDDQ）-皮肤科版本（BDDQ-DV）、BDDQ-美容外科（BDDQ-AS）、美容手术筛查问卷（COPS）和躯体变形症状量表（BDSS）是专门为BDD开发的，并在美容环境中得到了验证。本文还讨论了筛查工具的局限性。鉴于社交媒体的使用日益增加，BDD工具的未来修订应考虑纳入与患者在社交媒体上的行为相关的问题。尽管目前的筛查工具有局限性且需要更新，但仍能充分检测BDD。
