title: Prevalence of Body Dysmorphic Disorder Among Patients Seeking Breast Reconstruction.
abstract: BACKGROUND
  Body dysmorphic disorder (BDD) is characterized by a preoccupation with a slight or imagined defect in physical appearance. It has significant implications for patients who desire breast reconstruction, because patient satisfaction with the aesthetic outcome is a substantial contributor to the success of the procedure.
  
  
  OBJECTIVE
  The authors estimated the prevalence of BDD among women seeking breast reconstruction by surveying patients with the previously validated Dysmorphic Concerns Questionnaire (DCQ).
  
  
  METHODS
  One hundred eighty-eight women who presented for immediate or delayed breast reconstruction completed the DCQ anonymously, during initial consultation with a plastic surgeon. Two groups of respondents were identified: those who desired immediate reconstruction and those who planned to undergo delayed reconstruction. The prevalence of BDD among breast reconstruction patients was compared between the 2 groups, and the overall prevalence was compared with published rates for the general public.
  
  
  RESULTS
  Body dysmorphic disorder was significantly more prevalent in breast reconstruction patients than in the general population (17% vs 2%; P < .001). It also was much more common among patients who planned to undergo delayed (vs immediate) reconstruction (34% vs 13%; P = .004).
  
  
  CONCLUSIONS
  Relative to the general public, significantly more women who sought breast reconstruction were diagnosed as having BDD. Awareness of the potential for BDD will enable clinicians to better understand their patients' perspectives and discuss realistic expectations at the initial consultation. Future studies are warranted to examine the implications of BDD on patient satisfaction with reconstructive surgery.
  
  
  METHODS
  3.
authors.affiliation: Drs Metcalfe and Duggal are residents, Dr Carlson is the Chair, and Dr Losken is Program Director for Plastic Surgery, Division of Plastic and Reconstructive Surgery, Emory University Hospital, Atlanta, Georgia.
authors.forename: Drew B
authors.initials: DB
authors.lastname: Metcalfe
authors.affiliation: Drs Metcalfe and Duggal are residents, Dr Carlson is the Chair, and Dr Losken is Program Director for Plastic Surgery, Division of Plastic and Reconstructive Surgery, Emory University Hospital, Atlanta, Georgia.
authors.forename: Claire S
authors.initials: CS
authors.lastname: Duggal
authors.affiliation: Dr Gabriel is a plastic surgeon in private practice in Vancouver, Washington.
authors.forename: Allen
authors.initials: A
authors.lastname: Gabriel
authors.affiliation: Dr Nahabedian is a Professor of Surgery, Department of Plastic Surgery, Georgetown University, Washington, DC.
authors.forename: Maurice Y
authors.initials: MY
authors.lastname: Nahabedian
authors.affiliation: Drs Metcalfe and Duggal are residents, Dr Carlson is the Chair, and Dr Losken is Program Director for Plastic Surgery, Division of Plastic and Reconstructive Surgery, Emory University Hospital, Atlanta, Georgia.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Carlson
authors.affiliation: Drs Metcalfe and Duggal are residents, Dr Carlson is the Chair, and Dr Losken is Program Director for Plastic Surgery, Division of Plastic and Reconstructive Surgery, Emory University Hospital, Atlanta, Georgia alosken@emory.edu.
authors.forename: Albert
authors.initials: A
authors.lastname: Losken
mesh_terms: D000328:Adult; D000368:Aged; D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019928:Breast Implantation; D002170:Canada / Q000453:epidemiology; D004954:Esthetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D015995:Prevalence; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Dysmorphic Concerns Questionnaire (DCQ); body dysmorphic disorder (BDD); breast reconstruction; mastectomy; tissue expander; transverse rectus abdominis myocutaneous (TRAM) flap