title: Body-image, self-concept and mental exposure in patients with pectus excavatum.
abstract: BACKGROUND
  Pectus excavatum is the most common congenital anomaly of the sternum and anterior chest wall, which occurs about 3-4 times more often in boys than girls [1]. Although most patients do not report physical symptoms as cardiovascular and respiratory problems, they show a loss of self-esteem and a poor self-image. There exist very rare data about psychological state before the OP compared with data afterwards.
  
  
  OBJECTIVE
  This study was conducted to examine psychological changes in body-image, self-concept and mental exposure in patients with pectus excavatum, who had undergone the Nuss procedure.
  
  
  METHODS
  Seventeen patients (13 male, 4 female), who underwent 2003 a comprehensive psychological investigation, have been tested again in 2007 by means of the identical questionnaires to get postoperative data: OPE-FB (Wallisch; Operation-Expectation-Questionnaire), FKKS (Deusinger; Frankfurter Body Concept Scales) and SCL-90-R (Derogatis; Symptom Checklist Revised). The mean age at the second time of investigation was 19.6 years (SD = 2.5). The patients were classified into two groups based on a lower (n = 10) and a higher (n = 7) severity index of PE. Parents or a parent person were interviewed about the topics of OPE-FB by a structured interview. Data were analyzed using Mann-Whitney U test and Wilcoxon test. Interview data were evaluated with a content analysis.
  
  
  RESULTS
  Nearly all patient's expectations in regard to the beneficial effect of the surgical procedure-investigated with the OPE-FB preoperatively-have been confirmed postoperatively. In patients with a lower severity index impairment in general interest in sports and improvements in self-assurance, health, self-acceptance of one's body and acceptance of one's body by others can be reported. Data from SCL-90-R, measuring mental exposure, had normal range. Interviews with relatives showed, that the external attribution could emphasize patient's data from the OPE-FB.
  
  
  CONCLUSIONS
  The long-time follow-up can make us sure, that the Nuss procedure as a physical treatment has positive effects on physical as well as psychological aspects of young adults. The patient's confidence with the cosmetic result was very high, which reflects the excellent effects of the minimal invasive repair according to Nuss.
authors.affiliation: Department of Behavioural Medicine, Psychology of Health and Empirical Psychosomatics, University Clinic of Medical Psychology and Psychotherapy, Graz, Austria. barbara.hadolt@alumni.uni-graz.at
authors.forename: Barbara
authors.initials: B
authors.lastname: Hadolt
authors.forename: A
authors.initials: A
authors.lastname: Wallisch
authors.forename: J W
authors.initials: JW
authors.lastname: Egger
authors.forename: M E
authors.initials: ME
authors.lastname: Höllwarth
mesh_terms: D001828:Body Image; D032882:Comprehension; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods / Q000523:psychology*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult