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1.
Laryngorhinootologie ; 98(5): 325-332, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-31618775

RESUMO

BACKGROUND: The body dysmorphic disorder (BDD) is considered to be a sub-form of somatoform disorders. BDD can express itself in a delirious experience, an excessive evaluation and employment of the external appearance, in particular the face. Preliminary results suggest that individuals with BDD do not benefit from plastic surgery, so that aesthetic surgery often results in aggravation of their symptoms. Thus, the identification of signs for a BDD is crucial, whether a patient should be operated plastically-aesthetically. This overview explains the often difficult diagnostics of the BDD by summarizing the current literature on its screening. STUDY DESIGN: Systematic overview METHODS: An electronic search was conducted in the German and English-language literature in order to identify all screening instruments for the BDD. The specific development RESULTS: Six different screening instruments were identified for the BDD. Only two of these were evaluated in a cosmetic setting: the "Body Dysmorphic Disorder Questionnaire Dermatology Version" (BDDQ-DV) and the "Dysmorphic Concern Questionnaire" (DCQ). The influence on the subjective results after a plastic-aesthetic procedure was measured only for the DCQ. CONCLUSION: The limited availability of validated screening instruments for BDD in plastic surgery is markedly in contrast to the supposedly high prevalence of the disease of 2.4 %. Among the currently used screening tools, the BDDQ-DV and the DCQ appear to be most suitable. Further research efforts are needed to establish better screening methods for the BDD in the plastic surgical patient population and to examine the effects of BDD on treatment results.


Assuntos
Transtornos Dismórficos Corporais , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Transtornos Dismórficos Corporais/diagnóstico , Estética , Humanos , Inquéritos e Questionários
2.
PLoS One ; 14(5): e0213974, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31059514

RESUMO

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are potentially life-threatening conditions whose partially overlapping phenomenology-distorted perception of appearance, obsessions/compulsions, and limited insight-can make diagnostic distinction difficult in some cases. Accurate diagnosis is crucial, as the effective treatments for AN and BDD differ. To improve diagnostic accuracy and clarify the contributions of each of the multiple underlying factors, we developed a two-stage machine learning model that uses multimodal, neurobiology-based, and symptom-based quantitative data as features: task-based functional magnetic resonance imaging data using body visual stimuli, graph theory metrics of white matter connectivity from diffusor tensor imaging, and anxiety, depression, and insight psychometric scores. In a sample of unmedicated adults with BDD (n = 29), unmedicated adults with weight-restored AN (n = 24), and healthy controls (n = 31), the resulting model labeled individuals with an accuracy of 76%, significantly better than the chance accuracy of 35% ([Formula: see text]). In the multivariate model, reduced white matter global efficiency and better insight were associated more with AN than with BDD. These results improve our understanding of the relative contributions of the neurobiological characteristics and symptoms of these disorders. Moreover, this approach has the potential to aid clinicians in diagnosis, thereby leading to more tailored therapy.


Assuntos
Anorexia Nervosa/diagnóstico , Anorexia Nervosa/etiologia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/etiologia , Neuroimagem , Psicometria , Adolescente , Adulto , Biomarcadores , Análise de Dados , Diagnóstico Diferencial , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética , Masculino , Neuroimagem/métodos , Psicometria/métodos , Curva ROC , Adulto Jovem
3.
Nord J Psychiatry ; 73(4-5): 244-247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31074670

RESUMO

Background: Body dysmorphic disorder (BDD) is preoccupation with perceived body defects leading to distress and impairment in social functioning. Most of adolescent BDD literature has been done on patients within the outpatient setting with prior versions of DSM with dearth of information about BDD and comorbid psychiatric conditions among adolescents within the inpatient setting. Aims: This pilot study evaluated the prevalence rate, clinical characteristics in adolescent BDD compared to non-BDD adolescents in a psychiatric in patient setting in addition to their comorbid issues like anxiety, OCD, ADHD and substance abuse. Methods: Forty-five consecutively admitted adolescent patients participated with 17 meeting the DSM 5 criteria for BDD while 28 did not. Patients were asked four questions designed around the DSM-5 criteria for BDD after which they were asked to complete questionnaires like BDDQ child and adolescent version, BDDM, Multiaxial Anxiety Scale for Children, Children's Depression Inventory, Y-BOCS and Vanderbilt ADHD rating scales. Results: Seventeen participants had BDD. Mean age of BDD patients was 13.1 while non-BDD was 12.4. Male patients with BDD were seven (41%) while female BDD patients were 10 (58.8%). Anxiety, depression, OCD and substance use disorders were common comorbid diagnoses. Majority of patients in the BDD group classified their BDD as a severe problem with more BDD, patient's considering suicide because of their BDD. Discussion: BDD is present in adolescents admitted in inpatient psychiatric hospital with more female patients endorsing BDD versus their male counterparts. Patients with BDD are more likely to endorse more comorbid psychiatric issues such as anxiety, OCD, ADHD and substance abuse.


Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Hospitais Psiquiátricos , Pacientes Internados/psicologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Adolescente , Transtornos Dismórficos Corporais/diagnóstico , Criança , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização/tendências , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Projetos Piloto , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários
4.
J Otolaryngol Head Neck Surg ; 48(1): 20, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092284

RESUMO

The Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) is a validated questionnaire that is used as a screening tool for body dysmorphic disorder (BDD) in aesthetic rhinoplasty patients. The BDDQ-AS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 165 consecutive patients. Psychometric properties were evaluated using item-reponse theory (IRT). Internal consistency was high, with Cronbach's alpha of 0.90 (95% lower CL 0.88). While the discrimination abilities of all the items were good (over 2.0), their difficulty parameters were shifted towards greater severity of symptoms. That shift could also be observed in information function graph for the entire scale. In other words, the BDDQ-AS performed better in patients with more severe body dysmorphic symptoms. In conclusion, the BDDQ-AS was translated, adapted, and psychometrically validated for use in a French-speaking population.


Assuntos
Transtornos Dismórficos Corporais/diagnóstico , Comparação Transcultural , Rinoplastia , Inquéritos e Questionários , Adulto , Canadá , Feminino , Humanos , Linguagem , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Traduções
5.
Facial Plast Surg ; 35(2): 210-213, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30877682

RESUMO

The dynamics of the doctor-patient relationship has been complicated as more patients seem to expect perfection in this age of selfies and Internet postings. The preoperative patient interview is critical to recognize both body language clues and subtle but apparent red flags to avoid rhinoplasty on potentially unhappy patients. This interview should include routine use of a body dysmorphic disorder screening questionnaire since legions of these patients are undiagnosed prior to surgery and few, if any, are ever satisfied with even an excellent surgical result. These patients need diagnosis and psychological intervention-not surgery. Rapport is critical to patient and surgeon's satisfaction; therefore, it is valuable to practice the ABC's of rapport building: 1) active listening, (2) positive body language, and (3) candor.


Assuntos
Internet , Satisfação do Paciente , Relações Médico-Paciente , Rinoplastia , Transtornos Dismórficos Corporais/diagnóstico , Humanos
6.
Laeknabladid ; 105(3): 125-131, 2019 03.
Artigo em Islandês | MEDLINE | ID: mdl-30806630

RESUMO

Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with nonexistent or slight defects in appearance. BDD usually begins during childhood or adolescence. The preoccupation with the perceived appearance defect typically occurs for many hours a day and is often followed by repetitive behaviours (for example mirror checking and skin picking). The weighted prevalence of BDD in a community sample is around 2%, but it is higher in clinical settings and in cosmetic and dermatological settings. BDD leads to significant distress and/or impairment at work or school and is highly comorbid with major depressive disorder, alcohol or substance use disorder, social anxi-ety disorder and obsessive compulsive disorder and often leads to suicidal ideation. Research suggests that cognitive behavioral therapy (CBT) and SSRI medication are most effective for BDD. However, cosmetic and dermatological treatments rarely improve BDD, and are often harmful. This review contains information on how to screen and diagnose BDD. Further research on BDD and effective treatment for this often imparing disorder is needed.


Assuntos
Transtornos Dismórficos Corporais , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/terapia , Terapia Cognitivo-Comportamental , Técnicas Cosméticas , Humanos , Valor Preditivo dos Testes , Prevalência , Prognóstico , Fatores de Risco , Inibidores de Captação de Serotonina/uso terapêutico
7.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(1): 28-32, ene.-feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-176883

RESUMO

Introducción: El trastorno dismórfico corporal (TDC) es una enfermedad mental difícil de diagnosticar; puede causar una gran cantidad de sufrimiento, y el tratamiento a menudo es complejo y desafiante. Material y método: La población de estudio comprendía 81 pacientes ambulatorios dermatológicos consecutivos que cumplían los criterios de inclusión para la participación. Fueron tratados en hospitales en zonas urbanas (Zaragoza) y rurales (Alcañiz). Es un estudio piloto prospectivo y observacional. Se utilizaron como instrumentos de evaluación: a) La escala de gradación del acné de Cook y b) El Cuestionario de Trastorno Dismórfico Corporal (Body Dysmorphic Disorder Questionnaire, BDDQ) (traducción al español). Los posibles casos de TDC se identificaron mediante 2 criterios: 1) Un resultado positivo en el BDDQ (4 puntos positivos y una pregunta de exclusión negativa); y 2) Escala de gradación del acné de Cook que reflejó lesiones no perceptibles/leves (los criterios más estrictos) o lesiones moderadas (criterios menos estrictos) Resultados: El rango de edad de los pacientes era de 13 a 43 años. La edad promedio fue 19 con una desviación estándar de 6,2. De los 81 participantes, el 54,3% eran mujeres y el 45,7% eran hombres. El 61,7% vivía en el área rural cubierta por el hospital de Alcañiz y el 38,3% era del área urbana atendida por el Hospital Universitario de Zaragoza. Cuando se aplicaron criterios más restrictivos con respecto a la gravedad de la afección (solo los pacientes con acné leve), el proceso de detección de BDDQ resultó en una tasa de prevalencia de TDC del 8,6% (7 pacientes); si los criterios fueron menos restrictivos (incluidos los pacientes con lesiones moderadas), la tasa fue del 14,8% (12 pacientes). Discusión: Vale la pena recordar que los pacientes con TDC que participaron en este estudio pasan un promedio de 2 h al día pensando y preocupándose por su apariencia. Este hecho es un recordatorio de la importancia de diagnosticar y tratar correctamente el TDC ya que la afección claramente tiene un impacto serio y negativo en las vidas de los afectados


Introduction: Body dysmorphic disorder (BDD) is a mental health condition that is difficult to diagnose; it can cause a great deal of suffering, and treatment is often complex and challenging. Material and method: The study population comprised 81 consecutive dermatology out-patients who met the inclusion criteria for participation. Participants were treated at hospitals in both urban (Zaragoza) and rural areas (Alcañiz). The project was based on a prospective and observational pilot study. Assessment instruments used: Cook's Acne Grading Scale and Body Dysmorphic Disorder Questionnaire (BDDQ) (Spanish translation). Possible cases of BDD were identified by means of 2 criteria: 1) A positive result in the BDDQ (4 positive points and a negative exclusion question); and, 2) A Cook's Acne Grading Score that reflected non-noticeable/mild lesions (the most stringent criteria) or moderate lesions (least stringent criteria). Results: The age range of the patients was from 13 to 43 years old. The average age was 19 with a standard deviation of 6.2. Of the 81 participants, 54.3% were women. 61.7% were seen in a rural hospital (Alcañiz Hospital) and 38.3% in an urban one (University Hospital of Zaragoza). When more restrictive criteria regarding the seriousness of the condition were applied (only patients with mild acne), the BDDQ screening resulted in a positive BDD prevalence rate of 8.6% (7 patients); if the criteria were less restrictive (including patients with moderate lesions), the rate was 14.8% (12 patients)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Transtornos Dismórficos Corporais/diagnóstico , Acne Vulgar/diagnóstico , Projetos Piloto , Imagem Corporal , Transtornos Dismórficos Corporais/complicações , Acne Vulgar/fisiopatologia , Assistência Ambulatorial , Estudos Prospectivos , Estudo Observacional , Inquéritos e Questionários , Grupos de Risco , Saúde Mental , Autoavaliação Diagnóstica
8.
Body Image ; 28: 101-109, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30639976

RESUMO

Although appearance comparisons, self-monitoring, and appearance-related comments have been linked to body dissatisfaction in prior studies, the combined and unique influences of these variables on state body dissatisfaction in daily life has yet to be explored. The present study addressed this gap, and also evaluated whether these state-based effects were stronger for individuals with trait-level body image disturbances (internalization and body dissatisfaction). Eighty-four women completed baseline measures of trait internalization and body dissatisfaction, and then reported momentary experiences of body dissatisfaction, appearance self-monitoring, appearance-related comments, and appearance-based comparisons at up to 10 random times daily for seven days. Multilevel analyses confirmed that both appearance comparisons and commentary (both negative and positive) were predictive of changes in state body dissatisfaction when modelled individually as well as in a combined (full) model. Appearance self-monitoring was not a significant predictor, either individually or in the full model. These within-person relationships were not moderated by individual differences in trait body dissatisfaction and internalization of appearance standards. Accordingly, experiences of body dissatisfaction in daily life may be a common reaction to negative appearance comments and unflattering comparisons, yet positive comments and/or efforts to avoid appearance-based comparisons may have a positive effect on one's body image.


Assuntos
Transtornos Dismórficos Corporais/psicologia , Imagem Corporal/psicologia , Satisfação Pessoal , Aparência Física , Adolescente , Adulto , Transtornos Dismórficos Corporais/diagnóstico , Emoções , Retroalimentação Psicológica , Feminino , Humanos , Individualidade , Controle Interno-Externo , Masculino , Psicometria , Meio Social , Inquéritos e Questionários , Vitória , Adulto Jovem
9.
Body Image ; 28: 110-114, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30654275

RESUMO

Body dissatisfaction is linked to poor physical health, even after actual markers of health have been controlled for. This link is likely due to body dissatisfaction influencing health behaviors-more specifically, cardiovascular exercise. Modifiable reasons for this link have yet to be determined. We conducted a prospective study to evaluate whether active avoidance of exercise may explain the association of body dissatisfaction with exercise, and, if so, whether perceived barriers to exercise account for the association of body dissatisfaction and exercise avoidance. Baseline measures were collected via survey; physical activity was measured over time, via self-report. As expected, avoidance mediated the prospective relationship between dissatisfaction and exercise. Additionally, the relationship between body dissatisfaction and avoidance was mediated by embarrassment and fatigue. Interventions that boost body satisfaction and/or address perceptions of fatigue and embarrassment may be needed for individuals with body dissatisfaction to be more likely to participate in exercise-related programs.


Assuntos
Aprendizagem da Esquiva , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal/psicologia , Exercício/psicologia , Satisfação Pessoal , Adolescente , Adulto , Transtornos Dismórficos Corporais/diagnóstico , Constrangimento , Fadiga/psicologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Autorrelato , Inquéritos e Questionários , Adulto Jovem
10.
Psychiatry Res ; 272: 483-490, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30611968

RESUMO

Despite the literature suggesting that body dissatisfaction is increasing among males, only few measures on specific body image concerns in men have been validated in Spanish male populations. The aim of this study was to reassess the factor structure of the Spanish versions of the Muscle Dysmorphic Disorder Inventory (MMDI) and the Adonis Complex Questionnaire (ACQ). A cross-sectional study was conducted among 298 Sport Sciences male students to examine: reliability, the factorial structure, and several evidences of validity -concurrent and convergent- of both scales. The questionnaires present adequate reliability. The three-factor structure proposed for the MMDI was replicated. Nevertheless, the confirmatory factor analysis supports a second-order factor structure for the ACQ instead of the three-factor structure proposed. Moreover, the MDDI shows greater association than ACQ with the variables studied. This study represents an advance in the use of adequate and reliable scales of body image tools in the Hispanic population.


Assuntos
Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal/psicologia , Testes Neuropsicológicos/normas , Estudantes/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Transtornos Dismórficos Corporais/epidemiologia , Estudos Transversais , Emoções/fisiologia , Análise Fatorial , Humanos , Masculino , Músculo Esquelético/fisiologia , Psicometria , Reprodutibilidade dos Testes , Espanha/epidemiologia , Adulto Jovem
11.
Psychiatry Res ; 272: 349-358, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30599438

RESUMO

Checking behavior (CB) occurs in a variety of disorders such as obsessive-compulsive (OCD), body dysmorphic (BDD), illness anxiety (IA), and panic disorder (PD), as well as anorexia (AN) and bulimia nervosa (BN). Etiological models of these disorders - with the exception of those for PD - postulate that CB mainly occurs in situations characterized by negative affect and serves to regulate it. We aimed to test these assumptions: N = 386 individuals with a self-reported diagnosis of one of the disorders rated their affect at baseline, directly before a remembered CB episode, during, immediately afterwards, and 15 and 60 minutes afterwards, and rated their endorsement of different functions of CB. The results show that transdiagnostically negative affect is significantly higher before CB compared to baseline, and is significantly reduced from before CB to all post-CB assessments. Reduction of negative affect and Attainment of certainty were the sole functions predicting the affective course during CB, and most prominently reported transdiagnostically. Assumptions of the etiological models were confirmed, suggesting that exposure and ritual prevention should be examined across disorders. As attainment of certainty seems to be predictive for the course of CB, this might be targeted in cognitive interventions.


Assuntos
Anorexia Nervosa/psicologia , Transtornos Dismórficos Corporais/psicologia , Bulimia Nervosa/psicologia , Hipocondríase/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno de Pânico/psicologia , Adulto , Afeto/fisiologia , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Comorbidade , Feminino , Humanos , Hipocondríase/diagnóstico , Hipocondríase/epidemiologia , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/epidemiologia , Autorrelato/normas
12.
Psychiatry Res ; 272: 319-325, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30597384

RESUMO

Muscle dysmorphia is primarily characterized by an excessive preoccupation that one's body is not muscular or lean enough. Muscle dysmorphia has shown clinical similarities with eating disorders. The present study aims to explore the psychosocial factors underlying muscle dysmorphia symptoms by referring to Stice's dual pathway model (1994), a theoretical model of eating disorders. Three hundred and eighty-six men were recruited to complete an online survey including questionnaires assessing social pressures to reach a muscular body and internalization of the muscular body, drive for muscularity, muscular-enhancing behaviors, negative affect, narcissistic traits, and symptoms of muscle dysmorphia. Path analyses showed that the original model has a good fit, without, however, confirming a significant relationship between the drive for muscularity and negative affect. Thus, social pressure to reach a muscular body and its internalization were associated to a drive for muscularity and then, to muscle dysmorphia symptoms. The drive for muscularity was indirectly related to symptoms of muscle dysmorphia through muscle-enhancing behaviors as well as negative affect (although, only for individuals with higher levels of narcissistic vulnerability). Results supported the adaptation of the Stice's model to explain muscle dysmorphia symptoms and underlined the possible influence of narcissistic vulnerability traits in this condition.


Assuntos
Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal/psicologia , Músculo Esquelético , Percepção Social , Adolescente , Adulto , Transtornos Dismórficos Corporais/epidemiologia , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Humanos , Relações Interpessoais , Masculino , Músculo Esquelético/fisiologia , Inquéritos e Questionários , Adulto Jovem
13.
Actas Dermosifiliogr ; 110(1): 28-32, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30389124

RESUMO

INTRODUCTION: Body dysmorphic disorder (BDD) is a mental health condition that is difficult to diagnose; it can cause a great deal of suffering, and treatment is often complex and challenging. MATERIAL AND METHOD: The study population comprised 81 consecutive dermatology out-patients who met the inclusion criteria for participation. Participants were treated at hospitals in both urban (Zaragoza) and rural areas (Alcañiz). The project was based on a prospective and observational pilot study. Assessment instruments used: Cook's Acne Grading Scale and Body Dysmorphic Disorder Questionnaire (BDDQ) (Spanish translation). Possible cases of BDD were identified by means of 2 criteria: 1) A positive result in the BDDQ (4 positive points and a negative exclusion question); and, 2) A Cook's Acne Grading Score that reflected non-noticeable/mild lesions (the most stringent criteria) or moderate lesions (least stringent criteria) RESULTS: The age range of the patients was from 13 to 43 years old. The average age was 19 with a standard deviation of 6.2. Of the 81 participants, 54.3% were women. 61.7% were seen in a rural hospital (Alcañiz Hospital) and 38.3% in an urban one (University Hospital of Zaragoza). When more restrictive criteria regarding the seriousness of the condition were applied (only patients with mild acne), the BDDQ screening resulted in a positive BDD prevalence rate of 8.6% (7 patients); if the criteria were less restrictive (including patients with moderate lesions), the rate was 14.8% (12 patients). DISCUSION: Patients who screened positive for BDD reported spending an average of 2hours a day thinking and worrying about their appearance. These results highlight the importance of screening for possible cases of BDD in order to follow up these patients and recommend they be seen by a mental health specialist to confirm the diagnose and offer treatment for the disorder. BDD has a serious and negative impact on the lives of those affected.


Assuntos
Acne Vulgar/complicações , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/etiologia , Acne Vulgar/psicologia , Adolescente , Adulto , Transtornos Dismórficos Corporais/epidemiologia , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos , Adulto Jovem
14.
Curr Neuropharmacol ; 17(8): 697-702, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29701157

RESUMO

Body dysmorphic disorder is a challenging disorder that manifests as erroneously perceived flaws in one's physical appearance and repetitive behaviors in response to appearance concerns. This disorder is also frequently comorbid with other psychiatric disorders, including major depressive disorder and autism spectrum disorder. It is currently understood to arise from a combination of biological, psychological, and environmental factors. Treatment of body dysmorphic disorder typically consists of a combination of pharmacotherapy and cognitive behavioral therapy. However, not all patients respond to treatment, and BDD symptoms remain even in those who do respond. This review outlines current pharmacological and neuromodulation treatments for body dysmorphic disorder and suggests directions for future studies of novel treatments such as augmentation with atypical antipsychotics and the use of intranasal oxytocin in cases of body dysmorphic disorder that show residual symptomatology even with tailored monotherapy. There is emerging evidence suggesting that non-invasive neurostimulatory techniques, such as repetitive transcranial magnetic stimulation, may be of value in treatment-resistant cases.


Assuntos
Transtornos Dismórficos Corporais/tratamento farmacológico , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/etiologia , Humanos
15.
Am J Med Genet A ; 176(12): 2554-2560, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30475435

RESUMO

Polyamines serve a number of vital functions in humans, including regulation of cellular proliferation, intracellular signaling, and modulation of ion channels. Ornithine decarboxylase 1 (ODC1) is the rate-limiting enzyme in endogenous polyamine synthesis. In this report, we present four patients with a distinct neurometabolic disorder associated with de novo heterozygous, gain-of-function variants in the ODC1 gene. This disorder presents with global developmental delay, ectodermal abnormalities including alopecia, absolute or relative macrocephaly, and characteristic facial dysmorphisms. Neuroimaging variably demonstrates white matter abnormalities, prominent Virchow-Robin spaces, periventricular cysts, and abnormalities of the corpus callosum. Plasma clinical metabolomics analysis demonstrates elevation of N-acetylputrescine, the acetylated form of putrescine, with otherwise normal polyamine levels. Therapies aimed at reducing putrescine levels, including ODC1 inhibitors, dietary interventions, and antibiotics to reduce polyamine production by gastrointestinal flora could be considered as disease-modifying therapies. As the ODC1 gene has been implicated in neoplasia, cancer surveillance may be important in this disorder.


Assuntos
Alopecia/genética , Transtornos Dismórficos Corporais/genética , Transportadores de Ácidos Dicarboxílicos/genética , Mutação com Ganho de Função , Megalencefalia/genética , Proteínas de Transporte da Membrana Mitocondrial/genética , Transtornos do Neurodesenvolvimento/genética , Adolescente , Alelos , Alopecia/diagnóstico , Transtornos Dismórficos Corporais/diagnóstico , Encéfalo/anormalidades , Encéfalo/diagnóstico por imagem , Criança , Eletroencefalografia , Facies , Feminino , Genótipo , Humanos , Masculino , Megalencefalia/diagnóstico , Mutação , Transtornos do Neurodesenvolvimento/diagnóstico , Neuroimagem/métodos , Testes Neuropsicológicos , Fenótipo , Polimorfismo de Nucleotídeo Único
17.
Compr Psychiatry ; 87: 12-16, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30193152

RESUMO

Little is known about etiological factors in Body dysmorphic disorder (BDD). Cognitive behavioral and diathesis-stress models have implicated teasing and bullying as significant early environmental stressful triggers. Due to these implications, this study aimed to assess the emergence of BDD in children during early development, and to see if bullying experiences played a role in its development. A total of 219 children ages 7 to 10 were screened for psychopathology. Children were separated into four groups including a BDD group, an OCD group, a clinical control group (consisting of depressive disorders, attention deficit hyperactivity disorder, oppositional defiant disorder, and anxiety disorders not otherwise specified), and a non-clinical control group. Children were given questionnaires to evaluate their bullying and victimization experiences. It was hypothesized that children with BDD would experience more instances of victimization than children with OCD, clinical controls, and non-clinical controls. Contrary to the hypothesis, results indicated that children with BDD symptoms were significantly more likely to be perpetrators of bullying than the other groups [F (3, 27.082) = 17.892, p < .001]. In addition to scoring high on the bullying questionnaires, children with BDD scored high on victim questionnaires as well, suggesting a link between these two peer interpersonal conflicts. The results of this study suggest that bullying behavior might be an unknown characteristic in young children with emerging BDD pathology.


Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Bullying/psicologia , Vítimas de Crime/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos Dismórficos Corporais/diagnóstico , Escalas de Graduação Psiquiátrica Breve , Criança , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Grupo Associado , Prevalência
18.
Aust N Z J Psychiatry ; 52(11): 1030-1049, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30238784

RESUMO

OBJECTIVE: Current nosology conceptualises body dysmorphic disorder as being related to obsessive-compulsive disorder, but the direct evidence to support this conceptualisation is mixed. In this systematic review, we aimed to provide an integrated overview of research that has directly compared body dysmorphic disorder and obsessive-compulsive disorder. METHOD: The PubMed database was searched for empirical studies which had directly compared body dysmorphic disorder and obsessive-compulsive disorder groups across any subject matter. Of 379 records, 31 met inclusion criteria and were reviewed. RESULTS: Evidence of similarities between body dysmorphic disorder and obsessive-compulsive disorder was identified for broad illness features, including age of onset, illness course, symptom severity and level of functional impairment, as well as high perfectionism and high fear of negative evaluation. However, insight was clearly worse in body dysmorphic disorder than obsessive-compulsive disorder, and preliminary data also suggested unique visual processing features, impaired facial affect recognition, increased social anxiety severity and overall greater social-affective dysregulation in body dysmorphic disorder relative to obsessive-compulsive disorder. CONCLUSION: Limitations included a restricted number of studies overall, an absence of studies comparing biological parameters (e.g. neuroimaging), and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. Risks of interpreting common features as indications of shared underlying mechanisms are explored, and evidence of differences between the disorders are placed in the context of broader research findings. Overall, this review suggests that the current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.


Assuntos
Transtornos Dismórficos Corporais/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Diagnóstico Diferencial , Humanos
19.
Am J Med Genet A ; 176(12): 2548-2553, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30239107

RESUMO

The ornithine decarboxylase 1 (ODC1) gene plays an important role in physiological and cell developmental processes including embryogenesis, organogenesis, and neoplastic cell growth. Here, we report an 32-month-old Caucasian female with a heterozygous de novo nonsense mutation in the ODC1 gene that leads to a premature abrogation of 14-aa residues at the ODC protein c-terminus. This is the first human case confirming similar symptoms observed in a transgenic ODC1 mouse model first described over 20 years ago. Phenotypic manifestations include macrosomia, macrocephaly, developmental delay, alopecia, spasticity, hypotonia, cutaneous vascular malformation, delayed visual maturation, and sensorineural hearing loss. We here describe for the first time a new pediatric disorder that is directly linked to a de novo pathogenic variant in the ODC1 gene. The ODC1 gene mutation (c.1342 A>T) was identified by whole-exome sequencing and confirmed by Sanger sequencing. Red blood cells obtained from our patient showed elevated ODC protein and polyamine levels compared to healthy controls. Our autosomal dominant patient who carries this gain-of-function ODC1 mutation may benefit from treatment with α-difluoromethylornithine, a well-tolerated, U.S. Food and Drug Administration (FDA). FDA-approved drug.


Assuntos
Alopecia/diagnóstico , Alopecia/genética , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/genética , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/genética , Transportadores de Ácidos Dicarboxílicos/genética , Variação Genética , Proteínas de Transporte da Membrana Mitocondrial/genética , Sequência de Aminoácidos , Sequência de Bases , Transportadores de Ácidos Dicarboxílicos/química , Transportadores de Ácidos Dicarboxílicos/metabolismo , Eritrócitos/metabolismo , Feminino , Humanos , Lactente , Proteínas de Transporte da Membrana Mitocondrial/química , Proteínas de Transporte da Membrana Mitocondrial/metabolismo , Modelos Moleculares , Conformação Proteica , Relação Estrutura-Atividade , Sequenciamento Completo do Exoma
20.
Body Image ; 27: 1-9, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30086480

RESUMO

This study used network analyses to test the hypotheses that desire for thinness and fear of gaining weight are related but distinct constructs that play a central role in disordered eating. Data from a sample of 251 college women were used. Sparse undirected eating disorder symptom networks were calculated. Bootstrapped difference tests for edge weights and centrality indices were used to compare the position of desire for thinness and fear of gaining weight. Desire for thinness and fear of gaining weight exhibited unique patterns of associations within the network. Desire for thinness was highly connected to body dissatisfaction, thoughts about dieting, and thoughts about binge eating. Fear of gaining weight was not. Desire for thinness emerged as the most central symptom. Our findings support the distinction between fear of gaining weight and desire for thinness and their different roles within the eating disorder symptom network.


Assuntos
Imagem Corporal/psicologia , Medo , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Magreza/psicologia , Ganho de Peso , Adolescente , Sintomas Comportamentais/psicologia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Bulimia/psicologia , Dieta Redutora/psicologia , Feminino , Humanos , Motivação , Estudantes/psicologia , Adulto Jovem
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