National report — While it is difficult to pin down precise data regarding body dysmorphic disorder (BDD), sources tell Cosmetic Surgery Times it's more common than many cosmetic surgeons think. Perhaps more importantly, the link between BDD and suicide attempts makes it crucial to accurately identify and refer such patients for appropriate treatment, experts say. Seeking a predictive model
BDD prevalence Domestically, Dr. Fried says BDD's prevalence in dermatology patients is 11.9 percent, and it is estimated at around 20 percent in patients presenting for cosmetic procedures (Fried RG. Dermatologic Non-Disease. In: Lebwohl MG, Ed. Treatment of Skin Disease 2nd Edition. St. Louis: Mosby; 2006: 159-161.).
However, Dr. Vulink says that, compared to private facilities, academic settings, such as the one studied, usually see fewer BDD patients because such centers typically treat patients with difficult somatic problems. Moreover, "We don't yet have any prospective studies that look at what happens to a patient who has been diagnosed with BDD after the procedure or surgery," adds David Veale, M.D., consultant psychiatrist, Institute of Psychiatry, University of London. "We're trying to do that research ourselves, but it's quite difficult," partly because studying psychosocial factors isn't part of the cosmetic surgery culture, he adds. Dr. Veale invites interested cosmetic surgeons to contact him via his web site: http://www.veale.co.uk/. Complex diagnosis
In this regard, Dr. Vulink says, "it's very hard to get these patients to our offices. Patients are embarrassed" about seeing psychiatrists. Conversely, Dr. Fried says plastic surgeons and dermatologists attract such patients like magnets. And almost by definition, he adds, "doing a procedure on one of these patients can be disastrous for the patient — and potentially the surgeon." |
