Evaluating the Psychopathological Profile of Women Undergoing Reduction Mammaplasty With the Symptom Checklist-90-Revised.
BACKGROUND
Patients who desire reduction mammaplasty (RM) also may seek relief from social and emotional challenges that accompany their physical condition, including low self-confidence and impaired body image. Reduction mammaplasty is known to improve patients' physical and psychological well-being. It may be speculated that patients who undergo RM are motivated by psychological problems and have psychopathologies. Health care insurers reluctant to cover the expense of this surgery may cite mental health as a reason to deny coverage.


OBJECTIVE
The authors assessed the psychopathological profile of patients who presented for RM, utilizing a validated instrument, and compared scores with standard norm values.


METHODS
Preoperatively, 67 women were assessed with the Symptom Checklist-90-Revised (SCL-90-R), a validated instrument for evaluating a broad range of psychopathological problems and symptoms. The SCL-90-R provides a general psychoneurosis score, as well as scores for 8 symptom subscales.


RESULTS
The mean patient age was 36 ± 11.2 years. The mean (SD) total score on the SCL-90-R was 130 (38.7), which was not significantly higher than the norm score of 123. Only the subscores for somatization and sleep disturbance were significantly higher than the norm scores for these subscales. Compared with the norm score for women who presented with chronic pain, the total score for our study population was significantly lower.


CONCLUSIONS
Patients who undergo RM have normal scores for psychoneurosis according to the SCL-90-R. Health care insurance coverage for RM should not be denied on the basis that the motivation for surgery relates to psychopathology. Additionally, psychological testing is not recommended for most patients who desire breast reduction surgery; rather, clinical judgment based on common sense should be applied.


METHODS
3.
Drs Lapid and Corion are plastic surgeons, Academic Medical Centre, University of Amsterdam, the Netherlands o.lapid@amc.nl.
Oren
O
Lapid
Drs Lapid and Corion are plastic surgeons, Academic Medical Centre, University of Amsterdam, the Netherlands.
Leonard U M
LU
Corion
Dr Smeulders is a resident, Academic Medical Centre, University of Amsterdam, the Netherlands.
Mark J C S
MJ
Smeulders
Dr Swinkels is a Professor of Psychiatry in the Department of Psychiatry, Academic Medical Centre, University of Amsterdam, the Netherlands.
Jan A
JA
Swinkels
Dr van der Horst is a Professor and Head of the Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Centre, University of Amsterdam, the Netherlands.
Chantal M A M
CM
van der Horst
D000293:Adolescent; D000328:Adult; D000368:Aged; D001828:Body Image; D057189:Checklist; D004644:Emotions; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D018579:Patient Selection; D011788:Quality of Life; D000068436:Surgical Clearance; D055815:Young Adult
SCL-90–Revised; chronic pain; psychoneurosis; psychopathology; reduction mammaplasty