Body dysmorphic disorder is a mental disorder defined by an excessive preoccupation
about flaws of one's self-appearance even with little or no objective flaw present.
We examined patients undergoing septorhinoplasty retrospectively for BDD prevalence
and impact of a positive screening on postoperative health-related quality of life
(QOL).
104 patients who underwent septorhinoplasty at the University Hospital Heidelberg
completed two validated, disease-specific self-report questionnaires pre- and five
year postoperatively: The Rhinoplasty Outcomes Evaluation (ROE) and the Functional
Rhinoplasty Outcome Inventory (FROI)-17. To screen for BDD, the BDD Questionnaire
(BDDQ) was applied.
Fifty-one patients with complete data enrolled in our study, four patients screened
positive for BDD. Regarding all patients we found a significant gain in QOL pre- vs.
postoperatively in ROE and FROI-17 (p < 0.001). Patients with positive BDD screening
showed a lower improvement in the ROE score postoperatively than rest of the group
(25 vs. 33 points). The improvement of the ROE score in the BDD group was not significant.
In the FROI-17 there were no significant increases in the subcategories "self-esteem",
"general," "nasal symptoms" and in the overall score in the BDD group.
Prevalence of BDD in our collective was 7.8%. These patients showed no significant
gain in QOL after septorhinoplasty. Awareness of this patient group is obligatory
in order to prevent insufficient postoperative results as this specific patient group
may benefit from alternative treatments.
