Melbourne Institute of Plastic Surgery, 253 Wattletree Road, Melbourne, Australia.
Hammersmith and Fulham Improving Access to Psychological Therapies (IAPT), West London Mental Health Trust, 194 Hammersmith Road, London, UK.
Aesthetic Plast Surg. 2024 Jul;48(14):2738-2743. doi: 10.1007/s00266-024-03959-6. Epub 2024 Mar 27.
The Australian medical board, the Australian Health Practitioner Regulation Agency (AHPRA) has recently introduced new regulations mandating providers of cosmetic surgery undertake a clinical screen for body dysmorphic disorder (BDD) in all potential cosmetic surgery patients. The assessment must be conducted by the surgeon using a validated psychological screening tool. The aims of this paper are to discuss the key clinical characteristics of BDD before reviewing currently validated screening tools that would meet this new regulatory requirement, and which may be most applicable to a busy plastic surgery practice.
A literature search identified 1164 titles, of which 229 titles were retrieved for abstract screening. Six studies were identified that validated BDD screening tools in a setting relevant to cosmetic plastic surgery.
Six validated screening were identified: BDD Questionnaire (BDDQ), BDD Questionnaire Dermatology Version (BDDQ-DV), BDD Questionnaire Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), Body Dysmorphia Symptom Scale (BDSS) and the BDD Screening Test (BDD-ST). Our group practice has chosen to adopt the BDDQ-AS to meet the AHPRA regulator requirement for BDD screening based on its robust validation and ease of use in clinical practice, consisting of a seven-item self-report questionnaire that can be reliably completed in 1-2 minutes in most cases.
Of the six screening tools for body dysmorphic disorder available for use in clinical practice that have been validated in a cosmetic population setting, we have chosen to use the BDD Questionnaire Aesthetic Surgery (BDDQ-AS). To date all available validated screening tools are based on the DSM-IV, and further work to develop a validated screening tool based on the revised definition of BDD in the DSM-V is recommended, with a particular focus on items relating to repetitive physical or mental behaviours.
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澳大利亚医疗委员会，即澳大利亚健康从业者监管局（AHPRA）最近出台了新规定，要求所有潜在的整容手术患者都必须由外科医生使用经过验证的心理筛查工具对其进行躯体变形障碍（BDD）的临床筛查。该评估必须由外科医生使用经过验证的心理筛查工具进行。本文的目的是在审查目前符合这一新监管要求且可能最适用于繁忙的整形手术实践的经过验证的筛查工具之前，先讨论 BDD 的关键临床特征。
文献检索确定了 1164 个标题，其中有 229 个标题被检索用于摘要筛选。确定了六项研究，这些研究在与美容整形手术相关的环境中验证了 BDD 筛查工具。
确定了六个经过验证的筛查工具：躯体变形障碍问卷（BDDQ）、躯体变形障碍问卷皮肤病学版（BDDQ-DV）、躯体变形障碍问卷美容手术版（BDDQ-AS）、美容手术筛选问卷（COPS）、躯体变形障碍症状量表（BDSS）和躯体变形障碍筛查测试（BDD-ST）。我们的小组实践选择采用 BDDQ-AS 来满足 AHPRA 监管机构对 BDD 筛查的要求，因为它具有很强的验证性，并且在临床实践中易于使用，它由一个七项的自我报告问卷组成，在大多数情况下可以在 1-2 分钟内可靠地完成。
在经过验证并可用于美容人群环境的六种躯体变形障碍筛查工具中，我们选择使用躯体变形障碍问卷美容手术版（BDDQ-AS）。迄今为止，所有可用的经过验证的筛查工具都基于 DSM-IV，建议进一步开发基于 DSM-V 中躯体变形障碍修订定义的经过验证的筛查工具，特别关注与重复的身体或心理行为相关的项目。
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