title: High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty.
abstract: BACKGROUND
  Nasal aesthetic deformities may be associated with significant body image dissatisfaction. The only diagnostic category in the current list of psychiatric disorders that directly addresses these concerns is body dysmorphic disorder. This large-scale study determined the prevalence of body dysmorphic disorder and its symptoms in patients seeking rhinoplasty and evaluated the clinical profile of these patients.
  
  
  METHODS
  Two hundred twenty-six patients were given questionnaires including demographic characteristics, visual analogue scales for nasal shape, the Yale-Brown Obsessive Compulsive Scale modified for body dysmorphic disorder to assess severity of symptoms, a generic quality-of-life questionnaire, and the Derriford Appearance Scale 59, to assess appearance-related disruption of everyday living. Independent observers scored the nasal shape.
  
  
  RESULTS
  Thirty-three percent of patients showed at least moderate symptoms of body dysmorphic disorder. Aesthetic goals (p < 0.001), revision rhinoplasty (p = 0.003), and psychiatric history (p = 0.031) were associated with more severe symptoms. There was no correlation between the objective and subjective scoring of the nasal shape. Yale-Brown scale modified for body dysmorphic disorder scores correlated inversely with the subjective nasal scoring (n = 210, p < 0.001), without relation to the objective deformity of the nose. Body dysmorphic disorder symptoms significantly reduced the generic quality of life (n = 160, p < 0.001) and led to significant appearance-related disruption of everyday living (n = 161, p < 0.001).
  
  
  CONCLUSIONS
  The prevalence of moderate to severe body dysmorphic disorder symptoms in an aesthetic rhinoplasty population is high. Patients undergoing revision rhinoplasty and with psychiatric history are particularly at risk. Body dysmorphic disorder symptoms significantly reduce the quality of life and cause significant appearance-related disruption of everyday living.
  
  
  METHODS
  Risk, III.
authors.affiliation: Leuven, Belgium; and Heraklion, Greece From the Department of Otorhinolaryngology and the Psychiatric Department, University Hospitals Leuven, and the Department of Otorhinolaryngology, University Hospital Heraklion.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Picavet
authors.forename: Emmanuel P
authors.initials: EP
authors.lastname: Prokopakis
authors.forename: Lutgardis
authors.initials: L
authors.lastname: Gabriëls
authors.forename: Mark
authors.initials: M
authors.lastname: Jorissen
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hellings
mesh_terms: D000328:Adult; D001530:Belgium / Q000453:epidemiology; D057215:Body Dysmorphic Disorders / Q000453:epidemiology* / Q000209:etiology; D001828:Body Image; D005260:Female; D006801:Humans; D009110:Munchausen Syndrome / Q000150:complications* / Q000523:psychology; D009667:Nose Deformities, Acquired / Q000150:complications* / Q000523:psychology / Q000601:surgery; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000523:psychology*; D011795:Surveys and Questionnaires