The development of body dysmorphic disorder usually begins in adolescence, although it may take 10 years or more before diagnosis and treatment can be initiated. It was also found that the prevalence of this disorder among women is higher than among men (2.1% vs. 1.6%).
The median prevalence of body dysmorphic disorder among adults in the community is 1.9%, among adult patients receiving outpatient psychiatric care − 5.8%, among adult patients in psychiatric hospitals − 7.4%.
These figures indicate that, despite the prevalence of body dysmorphic disorder, the number of patients who receive qualified assistance is very small. Read on estet-portal.com how a cosmetologist can recognize this disease and what are the current approaches to treating dysmorphophobia.
Body Dysmorphophobia Prevalence Rate in Aesthetic Medicine
The rate of body dysmorphophobia in the field of aesthetic medicine is significantly higher compared to other areas, which should be taken into account by a cosmetologist in his practice.
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The structure of dysmorphophobia in aesthetic medicine tends to be: general cosmetic surgery − 13.2%; rhinoplasty − 20.1%; maxillofacial surgery − 1.2%; orthodontics and cosmetic dentistry − 5.2%; dermatology − 11.3%; cosmetology − 9.2%.
Considering the above, we can conclude that the majority of patients with body dysmorphic disorder turn to non-psychiatric specialists.
That is, every tenth patient in the practice of a cosmetologist, according to statistics, may have a history of signs of dysmorphophobia. But even in specialized conditions, the diagnosis of dysmorphophobia as a mental disorder is not effective enough. The level of diagnosis of the disease is very low, as patients report their symptoms on average only 15.1 ± 33.7% to psychiatrists or psychologists throughout life.
How to determine the psychotype of a patient and speak the same language with him
Therefore, it is so important for a cosmetologist to be able to identify the symptoms of the development of dysmorphophobia at an early stage, since doctors in the field of aesthetic medicine are the first link where patients can open up and thus the doctor can identify not only an external cosmetic defect, if it is inherent , but also to note the psychological component of dysmorphophobia.
For inconvenience, fear of condemnation, the feeling that the doctor will not understand the problems, patients do not advertise their condition. They don't know about the treatment, so they don't ask the doctor about it and thus don't know that body dysmorphic disorder is a big problem.
Trust Relationships – an important aspect of aesthetic medicine
Screening for dysmorphophobia in the practice of a cosmetologist
Special methods for detecting dysmorphophobia in patients have been developed, which can be used by a cosmetologist in his practice. The use of screening is beneficial, especially when evaluating patients with disorders that are comorbid with body dysmorphic disorder or may mask a true diagnosis of body dysmorphic disorder, such as depression, obsessive-compulsive disorder, or anxiety disorder.
An example of a screening that can be used is the BDD Questionnaire, which has a high sensitivity (94-100%) and specificity (89-93%) in detecting body dysmorphic disorder.
The role of a cosmetologist in the treatment of dysmorphophobia
For the treatment of body dysmorphic disorder, cognitive-behavioral and drug therapy is prescribed: selective serotonin reuptake inhibitors (fluoxetine, sertraline, paroxetine, citalopram, escitalopram, fluvoxamine) and tricyclic antidepressants (clomipramine), which also inhibits serotonin reuptake. Fluoxetine has been shown to be more effective for symptoms of body dysmorphic disorder.
Cognitive behavioral therapy for body dysmorphic disorder is aimed at creating an alternative understanding of patients' problems, reducing self-focus and the use of self-destructive coping strategies. In order to test their fears, patients are guided by behavioral experiments.
Aesthetic problems as a result of psychological problems: doctor's tactics
Often, patients visiting a psychotherapist or psychiatrist may not understand the doctor's beliefs about appearance and be ambivalent about psychological treatment. Therefore, it is at this stage of treatment that the expert opinion of a cosmetologist, as a specialist in the field of aesthetic medicine, can significantly affect the effectiveness of the treatment of dysmorphophobia and convince the patient that there is no problem in terms of aesthetics.
The synergy of a cosmetologist or a related specialist in the field of aesthetic medicine is very important, as many clinical studies have shown that cognitive behavioral therapy is more effective in reducing the severity of body dysmorphic symptoms, improving the quality of life and increasing the patient's level of critical attitude towards their condition .
Dysmorphophobia in the practice of a cosmetologist (Part 1)
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