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Objectives/Hypothesis
To validate a new screening tool for body dysmorphic disorder (BDD) in patients seeking aesthetic rhinoplasty.
The Laryngoscope
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Facial Plastics and Reconstructive Surgery
Body Dysmorphic Disorder in aesthetic rhinoplasty: Validating a new screening tool
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The authors have no funding, financial relationships, or conflicts of interest to disclose.
Abstract
Study Design
We performed a prospective instrument validation study in an academic rhinology clinic.
Methods
The Body Dysmorphic Disorder Questionnaire–Aesthetic Surgery (BDDQ-AS) is a seven-item short questionnaire validated in 116 patients undergoing aesthetic rhinoplasty. Screening was positive if the patient acknowledged on the BDDQ-AS that he/she was concerned about their appearance (question 1 = yes) AND preoccupied with these concerns (question 2 = yes) AND that these concerns caused at least moderate distress or impairment in different domains of daily life (question 3 or 4 or 5 or 6 ≥ 3 or question 7 = yes). Construct validity was assessed by comparing the BDDQ-AS to the Sheehan Disability Scale and the Derriford Appearance Scale-59. To determine concurrent validity, the BDDQ-AS was compared to the Yale-Brown Obsessive Compulsive Scale Modified for BDD. Finally, the predictive value of the BDDQ-AS on satisfaction 12 months after rhinoplasty was evaluated using a visual analogue scale and the Rhinoplasty Outcome Evaluation.
Results
Reliability of the BDDQ-AS was adequate, with Cronbach alpha = .83 for rhinoplasty patients and .84 for controls. Sensitivity was 89.6% and specificity 81.4%. BDDQ-AS–positive patients (n = 55) were more impaired in daily life and experienced more appearance-related distress and dysfunction compared to BDDQ-AS–negative patients. Moreover, they had more severe BDD symptoms. Finally, BDDQ-AS–positive patients were less satisfied after surgery compared to BDDQ-AS–negative patients.
Conclusions
We hereby validated a new screening tool for BDD in an aesthetic rhinoplasty population.
Level of Evidence
3b. Laryngoscope, 126:1739–1745, 2016