{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:53:33Z","timestamp":1784238813117,"version":"3.55.0"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aims to clarify the current concept of performing rhinoplasty in patients with possible body dysmorphic disorder (BDD). The primary objective was to investigate the validity and evolution over time of the Body Dysmorphic Disorder Questionnaire\u2014Aesthetic Surgery (BDDQ-AS) before and after surgery. Together with the BDDQ-AS, also the Nasal Obstruction Symptom Evaluation scale, FACE-Q nose and nostrils, and Utrecht questionnaire (UQ) were used for convergent validation. In this prospective study, 187 patients completed these patient-reported outcome measures at four time points: at the preoperative consultation and postoperatively at 3, 6 and 12 months. The preoperative BDDQ-AS positivity rate was as high as 55.1%. Postoperatively, there was a highly significant decrease in the odds of scoring positive on the BDDQ-AS. At the preoperative consultation, positively screened patients were less satisfied with the esthetics of their noses with worse scores on UQ, FACE-Q nose, and visual analog scale. The preoperative differences in outcome measure ratings disappeared postoperatively, except for the FACE-Q nostrils, which surprisingly showed better values in BDDQ-AS positive patients. Younger age and absence of nasal trauma were statistically significant covariates associated with positive BDDQ-AS screening. Due to the overwhelming decrease in positive BDDQ-AS outcomes after surgery, a positive screening result on the BDDQ-AS should not be interpreted as a formal contraindication for surgery. Collaboration with psychologists or psychiatrists remains crucial to diagnose BDD conclusively.<\/jats:p>","DOI":"10.1055\/a-2241-9934","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:04:15Z","timestamp":1704931455000},"page":"571-580","source":"Crossref","is-referenced-by-count":6,"title":["The Body Dysmorphic Disorder Questionnaire\u2014Aesthetic Surgery: Are We Screening the Troublesome Patients?"],"prefix":"10.1055","volume":"40","clinical-trial-number":[{"clinical-trial-number":"nct03925389","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6969-1565","authenticated-orcid":false,"given":"Frank","family":"Declau","sequence":"additional","affiliation":[{"name":"Department of ENT, Head and Neck Surgery, GZA-ziekenhuizen, Campus Sint-Vincentius, Antwerp, Belgium"},{"name":"Department of ENT, Head and Neck Surgery, Antwerp University School of Medicine and Health Sciences, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-3548","authenticated-orcid":false,"given":"Laura","family":"Pingnet","sequence":"additional","affiliation":[{"name":"Department of ENT, Head and Neck Surgery, Antwerp University School of Medicine and Health Sciences, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6352-9927","authenticated-orcid":false,"given":"Yannick","family":"Smolders","sequence":"additional","affiliation":[{"name":"Department of ENT, Head and Neck Surgery, Antwerp University School of Medicine and Health Sciences, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7785-4790","authenticated-orcid":false,"given":"Erik","family":"Fransen","sequence":"additional","affiliation":[{"name":"Centre of Medical Genetics, University of Antwerp, and Antwerp University Hospital, Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-9499","authenticated-orcid":false,"given":"Val\u00e9rie","family":"Verkest","sequence":"additional","affiliation":[{"name":"Department of ENT, Head and Neck Surgery, GZA-ziekenhuizen, Campus Sint-Vincentius, Antwerp, Belgium"},{"name":"Department of ENT, Head and Neck Surgery, Antwerp University School of Medicine and Health Sciences, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"ref1","volume-title":"Broken Mirror: Understanding and Treating Body Dysmorphic Disorder","author":"K A Phillips","year":"2005"},{"key":"ref2","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5","author":"A P Association","year":"2013","edition":"5th ed."},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1176\/appi.psy.46.4.317","article-title":"Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder","volume":"46","author":"K A Phillips","year":"2005","journal-title":"Psychosomatics"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/PRS.0b013e31821b631f","article-title":"High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty","volume":"128","author":"V A Picavet","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00005053-200003000-00007","article-title":"Quality of life for patients with body dysmorphic disorder","volume":"188","author":"K A Phillips","year":"2000","journal-title":"J Nerv Ment Dis"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"e1495","DOI":"10.1002\/hsr2.1495","article-title":"Prevalence of body dysmorphic disorder in rhinoplasty candidates: a systematic review and meta-analysis","volume":"6","author":"S S Nabavizadeh","year":"2023","journal-title":"Health Sci Rep"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s00266-020-01930-9","article-title":"Body dysmorphic disorder in rhinoplasty candidates: prevalence and functional correlations","volume":"45","author":"T SC de Souza","year":"2021","journal-title":"Aesthetic Plast Surg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.psc.2014.05.003","article-title":"Body dysmorphic disorder","volume":"37","author":"A Fang","year":"2014","journal-title":"Psychiatr Clin North Am"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"221","DOI":"10.31887\/DCNS.2010.12.2\/abjornsson","article-title":"Body dysmorphic disorder","volume":"12","author":"A S Bjornsson","year":"2010","journal-title":"Dialogues Clin Neurosci"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/01455613211056543","article-title":"Prevalence of body dysmorphic disorder among rhinoplasty candidates: a systematic review","volume":"103","author":"I AlAwadh","year":"2024","journal-title":"Ear Nose Throat J"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1007\/s00266-018-1300-1","article-title":"High prevalence of body dysmorphic disorder and moderate to severe appearance-related obsessive-compulsive symptoms among rhinoplasty candidates","volume":"43","author":"T D Ramos","year":"2019","journal-title":"Aesthetic Plast Surg"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.bjps.2010.09.019","article-title":"Body dysmorphic disorder and other psychiatric morbidity in aesthetic rhinoplasty candidates","volume":"64","author":"M Alavi","year":"2011","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/01.prs.0000475753.33215.8f","article-title":"Body dysmorphic disorder in patients seeking abdominoplasty, rhinoplasty, and rhytidectomy","volume":"137","author":"M JA de Brito","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00238-002-0408-2","article-title":"The importance of recognizing body dysmorphic disorder in cosmetic surgery patients: do our patients need a preoperative psychiatric evaluation?","volume":"25","author":"V Vindigni","year":"2002","journal-title":"Eur J Plast Surg"},{"issue":"07","key":"ref15","first-page":"51","article-title":"The presentation of body dysmorphic disorder in medical settings","volume":"13","author":"K A Phillips","year":"2006","journal-title":"Prim Psychiatry"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1089\/fpsam.2023.0212","article-title":"Prevalence and characteristics associated with positive body dysmorphic disorder screening among patients presenting for cosmetic facial plastic surgery","volume":"26","author":"E X Wei","year":"2024","journal-title":"Facial Plast Surg Aesthet Med"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ijwd.2017.09.007","article-title":"Cosmetic surgery and body dysmorphic disorder\u2014an update","volume":"4","author":"S Higgins","year":"2017","journal-title":"Int J Womens Dermatol"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.comppsych.2005.07.002","article-title":"Gender similarities and differences in 200 individuals with body dysmorphic disorder","volume":"47","author":"K A Phillips","year":"2006","journal-title":"Compr Psychiatry"},{"key":"ref19","volume-title":"Body Dysmorphic Disorder: Advances in Research and Clinical Practice","author":"K A Phillips","year":"2017"},{"issue":"03","key":"ref20","first-page":"204","article-title":"Ethics and the psychiatry journal editor: responsibilities and dilemmas","volume":"51","author":"D Greenberg","year":"2014","journal-title":"Isr J Psychiatry Relat Sci"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/YIC.0000000000000342","article-title":"Body dysmorphic disorder: a treatment synthesis and consensus on behalf of the International College of Obsessive-Compulsive Spectrum Disorders and the Obsessive Compulsive and Related Disorders Network of the European College of Neuropsychopharmacology","volume":"36","author":"D Castle","year":"2021","journal-title":"Int Clin Psychopharmacol"},{"issue":"03","key":"ref22","first-page":"e22965","article-title":"Video conferencing dysmorphia: assessment of pandemic-related body dysmorphia and implications for the post-lockdown era","volume":"14","author":"A Sarangi","year":"2022","journal-title":"Cureus"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1176\/appi.psy.42.6.504","article-title":"Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder","volume":"42","author":"K A Phillips","year":"2001","journal-title":"Psychosomatics"},{"issue":"02","key":"ref24","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1192\/bjp.169.2.196","article-title":"Body dysmorphic disorder. A survey of fifty cases","volume":"169","author":"D Veale","year":"1996","journal-title":"Br J Psychiatry"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"106","DOI":"10.4103\/ipj.ipj_58_17","article-title":"Selfie use: the implications for psychopathology expression of body dysmorphic disorder","volume":"26","author":"A Khanna","year":"2017","journal-title":"Ind Psychiatry J"},{"issue":"07","key":"ref26","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1111\/jocd.15685","article-title":"Evidence-based review: screening body dysmorphic disorder in aesthetic clinical settings","volume":"22","author":"I N Pereira","year":"2023","journal-title":"J Cosmet Dermatol"},{"issue":"08","key":"ref27","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1002\/lary.25963","article-title":"Body dysmorphic disorder in aesthetic rhinoplasty: validating a new screening tool","volume":"126","author":"G Lekakis","year":"2016","journal-title":"Laryngoscope"},{"issue":"12","key":"ref28","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1093\/asj\/sjaa004","article-title":"Correlation of the standardized cosmesis and health nasal outcomes survey with psychiatric screening tools","volume":"40","author":"E A Spataro","year":"2020","journal-title":"Aesthet Surg J"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.otohns.2003.09.016","article-title":"Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale","volume":"130","author":"M G Stewart","year":"2004","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1001\/jamafacial.2015.1445","article-title":"Development and psychometric evaluation of the FACE-Q Scales for patients undergoing rhinoplasty","volume":"18","author":"A F Klassen","year":"2016","journal-title":"JAMA Facial Plast Surg"},{"issue":"06","key":"ref31","doi-asserted-by":"crossref","first-page":"913e","DOI":"10.1097\/01.prs.0000434403.83692.95","article-title":"Benefits of a short, practical questionnaire to measure subjective perception of nasal appearance after aesthetic rhinoplasty","volume":"132","author":"P JFM Lohuis","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1093\/biomet\/72.3.497","article-title":"Maximum likelihood estimation for mixed continuous and categorical data with missing values","volume":"72","author":"R J Little","year":"1985","journal-title":"Biometrika"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1001\/jamafacial.2014.1492","article-title":"Body dysmorphic disorder in a facial plastic and reconstructive surgery clinic: measuring prevalence, assessing comorbidities, and validating a feasible screening instrument","volume":"17","author":"J K Dey","year":"2015","journal-title":"JAMA Facial Plast Surg"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1001\/jamafacial.2016.1535","article-title":"Prevalence of body dysmorphic disorder and surgeon diagnostic accuracy in facial plastic and oculoplastic surgery clinics","volume":"19","author":"A W Joseph","year":"2017","journal-title":"JAMA Facial Plast Surg"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1186\/s12888-021-03185-3","article-title":"Body dysmorphic disorder and self-esteem: a meta-analysis","volume":"21","author":"N Kuck","year":"2021","journal-title":"BMC Psychiatry"},{"issue":"10","key":"ref36","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1037\/bul0000161","article-title":"Development of self-esteem from age 4 to 94 years: a meta-analysis of longitudinal studies","volume":"144","author":"U Orth","year":"2018","journal-title":"Psychol Bull"},{"issue":"07","key":"ref37","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.comppsych.2013.03.019","article-title":"Age at onset and clinical correlates in body dysmorphic disorder","volume":"54","author":"A S Bjornsson","year":"2013","journal-title":"Compr Psychiatry"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"160","DOI":"10.12968\/bjon.2021.30.3.160","article-title":"Body dysmorphic disorder in children and young people","volume":"30","author":"C Watson","year":"2021","journal-title":"Br J Nurs"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"172e","DOI":"10.1097\/PRS.0000000000008031","article-title":"The zoom view: how does video conferencing affect what our patients see in themselves, and how can we do right by them?","volume":"148","author":"D A Daar","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref40","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/PRS.0b013e3182818f02","article-title":"Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty","volume":"131","author":"V A Picavet","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref41","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.bjps.2014.01.002","article-title":"Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty","volume":"67","author":"G A Felix","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"10","key":"ref42","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.bjps.2007.12.093","article-title":"The effects of cosmetic surgery on body image, self-esteem, and psychological problems","volume":"62","author":"T von Soest","year":"2009","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"05","key":"ref43","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1080\/13548500903112374","article-title":"Psychological change after aesthetic plastic surgery: a prospective controlled outcome study","volume":"14","author":"T P Moss","year":"2009","journal-title":"Psychol Health Med"},{"issue":"03","key":"ref44","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.asj.2005.03.009","article-title":"A prospective, multi-site investigation of patient satisfaction and psychosocial status following cosmetic surgery","volume":"25","author":"D B Sarwer","year":"2005","journal-title":"Aesthet Surg J"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2241-9934.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:21:18Z","timestamp":1730812878000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2241-9934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":44,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2024,9,17]]},"published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2241-9934","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"value":"0736-6825","type":"print"},{"value":"1098-8793","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,10]]},"published":{"date-parts":[[2024,1,10]]}}}