Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 68
An. bras. dermatol ; 96(1): 40-46, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1152804


Abstract Background: Body dysmorphic disorder consists of excessive concern with minimal appearance defects, which causes functional impairment. Its prevalence is estimated to range from 5% to 35% of dermatological patients, especially adult women with esthetic complaints. Objectives: To investigate the prevalence and factors associated with dysmorphic disorder in female dermatological patients, in a public institution in Brazil. Methods: This was a cross-sectional study involving adult women attended at a public dermatological service in Brazil. Participants underwent a demographic survey, in addition to a screening form for body dysmorphic disorder (Body Dysmorphic Disorder Examination [BDDE]). The presence of dysmorphic disorder (BDDE > 66 points) was assessed among the participants according to demographic covariates and psychological problems, through logistic regression. Results: A total of 223 women were evaluated. The BDDE showed high internal consistency (Cronbach's α = 0.90). It is noteworthy the high prevalence of psychological problems and the fact that over one-third (38%) of the sample presented a high degree of dissatisfaction with their image. The prevalence of dysmorphic disorder was 48% among women with esthetic complaints and 30% among the others (p < 0.01). Lower family income (OR = 2.97), history of domestic violence (OR = 3.23), search for dermatological care due to an esthetic complaint (OR = 2.05), and suicidal ideation (OR = 4.22) were independently associated with the occurrence of body dysmorphic disorder. Study limitations: This was a single-center study of a non-randomized sample from public service. Conclusions: Body dysmorphic disorder is prevalent among female dermatological patients; it is associated with traumatic psychological experiences, lower income, affective disorders, and demand for esthetic care. It is essential to recognize the diagnosis in order to treat such patients and refer them for appropriate psychiatric treatment instead of trying to satisfy their esthetic demands.

Humans , Female , Adult , Body Dysmorphic Disorders/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Esthetics
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 33-39, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055365


Objective: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. Methods: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients' dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. Results: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. Conclusion: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.

Humans , Female , Adult , Young Adult , Pituitary Neoplasms/psychology , Hyperprolactinemia/psychology , Prolactinoma/psychology , Body Dysmorphic Disorders/psychology , Pituitary Neoplasms/blood , Prolactin/blood , Psychiatric Status Rating Scales , Reference Values , Body Image/psychology , Hyperprolactinemia/drug therapy , Hyperprolactinemia/blood , Prolactinoma/blood , Body Mass Index , Surveys and Questionnaires , Statistics, Nonparametric , Dopamine Agonists/therapeutic use , Middle Aged
Article in English | LILACS | ID: biblio-1057226


ABSTRACT Objective: For every 100 random children diagnosed with autism, at least 20 have morphological abnormalities, often associated with syndromes. Brazil does not have a standardized and validated instrument for morphological physical examination. This study aimed to translate into Brazilian Portuguese and culturally adapt the clinical signs described in the Autism Dysmorphology Measure, as well as validate the instrument in a sample of children with autism. Methods: The original instrument was translated, culturally adapted, and published in full, following traditional procedures for translation, back-translation, and terminology adaptation according to the Nomina Anatomica. The sample included 62 children from a published multicenter study, with intelligence quotient between 50-69, of both genders, with chronological age between 3-6 years. Two clinical geneticists performed the morphological physical examination, which consisted of investigating 82 characteristics assessing 12 body areas. We used Cohen's Kappa coefficient to evaluate the agreement between the two observers. Results: The final version of the instrument - translated into Brazilian Portuguese and culturally adapted - showed high agreement between the two observers. Conclusions: The translated instrument meets all international criteria, and minor anomalies and their clinical descriptions were standardized and are recognizable for physicians not specialized in genetics.

RESUMO Objetivo: Entre 100 crianças, não selecionadas, com diagnóstico de autismo, pelo menos 20 apresentam anomalias morfológicas, quase sempre associadas a síndromes. Não há no Brasil instrumento de exame físico morfológico padronizado e validado. O objetivo foi traduzir para o português do Brasil e adaptar culturalmente os sinais clínicos descritos no Autism Dysmorphology Measure, assim como procurar evidências de validade quando aplicado a uma amostra de crianças com autismo. Métodos: Foram feitas a tradução e a adaptação cultural do instrumento original, publicado na íntegra. Foram adotados os procedimentos tradicionais de tradução, retrotradução e adaptação da terminologia segundo a Nomina Anatomica. Foram incluídas na amostra 62 crianças com quociente de inteligência entre 50 e 69, de ambos os sexos, com idade cronológica entre três e seis anos, provenientes de estudo multicêntrico com os procedimentos metodológicos já publicados. O exame físico morfológico foi realizado por dois médicos geneticistas e consistiu na pesquisa de 82 características que avaliam 12 áreas corporais. Para avaliar a concordância entre os dois observadores foi utilizado o coeficiente Kappa de Cohen. Resultados: A versão final do instrumento traduzido e adaptado culturalmente ao português do Brasil mostrou alta concordância entre os dois observadores. Conclusões: O instrumento traduzido preenche todos os critérios propostos internacionalmente e o reconhecimento das anomalias menores e sua descrição clínica estão padronizados e são de fácil reconhecimento aos médicos não especialistas em genética.

Humans , Male , Female , Child, Preschool , Child , Physical Examination/methods , Congenital Abnormalities/diagnosis , Congenital Abnormalities/genetics , Adaptation, Psychological/physiology , Autism Spectrum Disorder/psychology , Translations , Brazil/epidemiology , Surveys and Questionnaires , Reproducibility of Results , Cultural Characteristics , Body Dysmorphic Disorders/psychology , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/genetics
Med. leg. Costa Rica ; 36(2): 46-55, sep.-dic. 2019. tab
Article in Spanish | LILACS | ID: biblio-1040444


Resumen La anorexia nerviosa se caracteriza por una sobreestimación del volumen y forma del cuerpo, que conlleva a una búsqueda de la delgadez mediante dietas rígidas. Esta se presenta en 0.6% de la población mundial, siendo las mujeres adolescentes quienes más la padecen y ocurriendo en pacientes cada vez más jóvenes. Con respecto a los criterios diagnósticos, actualmente no se cuenta con rubros o guías específicas para la población pediátrica, lo que dificulta su valoración. En cuanto al tratamiento, se recomienda la realimentación progresiva alcanzar el peso esperado para el sexo y edad del paciente, en conjunto con terapia psicológica individual y familiar. Se concluye que es fundamental para el abordaje de la anorexia nerviosa ampliar la investigación para asegurar que las particularidades de esta en la población pediátrica, en su diagnóstico, tratamiento y prevención, sean contempladas. Asimismo, se insiste en la necesidad del trabajo interdisciplinario para lograr una recuperación integral.

Abstract Anorexia nervosa is a disorder characterized by an overestimation of the volume and shape of the body, which leads them to seek excessive thinness through rigid diets. It occurs in 0.6% of the world population, mostly affecting teenage girls and increasingly occurring in young patients. Nowadays, there are no specific guidelines for anorexia nervosa in pediatric patients which complicates its assessment. The recommended treatment is progressive feeding until the patient gains the expected weight for the patient, according to his sex and age, alongside individual and family therapy. It is concluded that further research is key to assure that the particularities of diagnosis, treatment and prevention of the disorder in pediatric patients are contemplated. Likewise, interdisciplinary work is necessary to achieve an integral approach.

Humans , Pediatrics , Body Image , Anorexia Nervosa/diagnosis , Anorexia Nervosa/physiopathology , Anorexia Nervosa/epidemiology , Feeding and Eating Disorders , Feeding Behavior , Body Dysmorphic Disorders
An. bras. dermatol ; 94(4): 422-428, July-Aug. 2019. tab
Article in English | LILACS | ID: biblio-1038314


Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Anxiety/epidemiology , Skin Diseases/psychology , Skin Diseases/epidemiology , Depression/epidemiology , Body Dysmorphic Disorders/psychology , Body Dysmorphic Disorders/epidemiology , Psychiatric Status Rating Scales , Socioeconomic Factors , Test Anxiety Scale , Time Factors , Logistic Models , Prevalence , Cross-Sectional Studies , Sex Distribution , Age Distribution , Statistics, Nonparametric , Nigeria/epidemiology
Medisan ; 23(4)jul.-ago. 2019. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1091120


Se describe el caso clínico de una adolescente de 16 años de edad, con aparente buen estado de salud, quien había sido atendida desde hacía 3 años aproximadamente en la consulta de Pediatría por presentar falta de desarrollo puberal, amenorrea primaria, así como aumento de volumen en miembros inferiores. Se le realizaron los exámenes complementarios pertinentes y dado el conjunto de elementos clínicos que presentaba, incluida una proteinuria significativa asociada a dismorfismos corporales e hipogenitalismo, se consultó el caso con un equipo multidisciplinario, integrado por nefrólogos, endocrinólogos, genetistas y psicólogos. Se le diagnosticó el síndrome de Frasier, como una asociación síndrome nefrótico-disgenesia gonadal.

The case report of a 16 years adolescent with apparent good health state who had been attended approximately for 3 years in the Pediatrics service to present lack of puberal changes, primary amenorrhoea, as well as increase of volume in lower members is described. The pertinent and complementary examinations were carried out and taking into account the group of clinical elements she presented, including a significant proteinuria associated with corporal dysmorfisms and hypogenitalism, the case was exposed to a multidisciplinary team, formed by nephrologists, Endocrinology specialists, geneticists and psychologists. Frasier syndrome was diagnosed, associated to nephrotic syndrome and gonadal dysgenesis.

Adolescent , Frasier Syndrome , Body Dysmorphic Disorders , Gonadal Dysgenesis , Proteinuria , Nephrotic Syndrome
Rev. bras. cir. plást ; 34(1): 108-112, jan.-mar. 2019.
Article in English, Portuguese | LILACS | ID: biblio-994559


O transtorno dismórfico corporal é encontrado com uma certa frequência nos atendimentos relacionados à estética. Entretanto, permanece subdiagnosticado devido à dificuldade de diferenciar uma insatisfação pessoal natural com a imagem corporal de uma queixa patológica. Para os pacientes com TDC, o incômodo gerado pelo seu "defeito" costuma ser desproporcional ao que observamos no exame físico. Além disso, na tentativa de corrigir aquilo que não lhe agrada, ele se submete a diversos procedimentos cirúrgicos que, em grande parte das vezes, considerará insuficiente para a resolução do seu problema. Nesse sentido, buscamos, com este trabalho, ampliar as discussões já existentes na literatura especializada. Assim, assumindo a escassa bibliografia, tencionamos, além de construir discussões acerca dessa afecção, o que pode contribuir para a identificação dos traços desse transtorno, evitando, por conseguinte, a realização de procedimentos cirúrgicos desnecessários e nortear as ações do especialista no que diz respeito à possibilidade de uma disputa judicial.

Body dysmorphic disorder (BDD) is found with a certain frequency in aesthetic-related care. However, it is underdiagnosed due to the difficulty in differentiating a personal dissatisfaction with body image of a pathological complaint. For BDD patients, the discomfort generated by their "defect" is often disproportionate to that observed on physical examination. In addition, in an attempt to correct their "defect", the patients undergoes various surgical procedures, which are often considered insufficient by the patients to solve their problem. Hence, this study aimed to expand the already existing discussions in the specialized literature. Since there are only a few studies on the topic, we plan to discuss this condition so as to contribute towards identification of the characteristics of this disorder, thus, avoiding unnecessary surgical procedures and guiding the specialist's actions in case of a legal dispute.

Male , Female , Adolescent , Adult , Middle Aged , Patients , Surgery, Plastic/methods , Reconstructive Surgical Procedures/adverse effects , Reconstructive Surgical Procedures/methods , Body Dysmorphic Disorders/surgery , Body Dysmorphic Disorders/complications , Body Dysmorphic Disorders/physiopathology , Body Dysmorphic Disorders/rehabilitation
Rio de Janeiro; s.n; 2019. 179 f p. fig, il, tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1016416


O desejo pela amputação de membros saudáveis tem sido chamado de apotemnophilia, transability, body integrity Identity disorder e xenomelia. Nessa condição rara, o indivíduo considerado saudável física e mentalmente apresenta um desejo intenso e duradouro de amputação. Ao relacionar esse fenômeno com outras formas de transformação corporal, como a body modification, tatuagem, piercing, cirurgias plásticas estéticas e cirurgias com fins médicos, verifica-se que o desejo pela amputação voluntária representa um caso único, singular. Ainda sem uma nosologia médico-psiquiátrica, esse fenômeno tem sido capturado por diversas áreas de saber em uma tentativa de conhecer sua etiologia, compreender sua fenomenologia e propor critérios diagnósticos e de tratamento adequados. Enquanto as formas de tratamento medicamentoso e psicoterapêutico têm se mostrado ineficazes, a cirurgia cada vez mais emerge como a única solução viável mas ainda não possível legalmente. A autonomia dos corpos é regulada pelas leis e pelo dispositivo médico que, até o momento, consideram essa demanda uma forma de agressão à integralidade do corpo e uma possível expressão de um transtorno mental ou neurológico. Devido ao estigma que essa condição recebe, os indivíduos preferem se manter no anonimato e esconder seu desejo. Suas causas são ainda desconhecidas, mas sabemos que é na infância que esse desejo se instala. A quantidade de membros a ser amputados varia, chegando a casos extremos de quádrupla amputação. A linha de amputação pode ser exata, mas o desejo pode migrar de membro. Esse desejo, mesmo sempre presente, pode apresentar variações em sua intensidade. A simulação da deficiência desejada e a automutilação são algumas práticas realizadas pelos que não sustentam a angústia desse desejo. Nesse contexto, as demandas por cegueira, surdez e paralisia também devem ser contempladas. Ao desejarem voluntariamente representar um corpo fora da normalidade, esses indivíduos questionam e desafiam as definições de autonomia, normalidade, integridade corporal, deficiência e incapacidade

The desire for amputation of healthy limbs has been called apotemnophilia, transability, body integrity identity disorder and xenomelia. In this rare condition, the individual considered physically and mentally healthy presents an intense and lasting desire for amputation. By relating this phenomenon to other forms of body transformation, such as body modification, tattooing, piercing, aesthetic plastic surgeries and medical surgeries, the desire for voluntary amputation represents a unique, singular case. Even without a medical-psychiatric nosology, this phenomenon has been captured by several areas of knowledge in an attempt to know its etiology, to understand its phenomenology and to propose adequate diagnostic and treatment criteria. While forms of drug and psychotherapeutic treatment have proved to be ineffective, surgery increasingly emerges as the only viable solution but not yet legally possible. The autonomy of bodies is regulated by the laws and medical devices that, to date, consider this demand as a form of aggression to the integrality of the body and a possible expression of a mental or neurological disorder. Because of the stigma that this condition receives, individuals prefer to remain anonymous and hide their desire. Its causes are still unknown, but we know that it is in childhood that this desire is installed. The number of limbs to be amputated varies, reaching extreme cases of quadruple amputation. The amputation line may be exact, but the desire may migrate from limb. Even this desire, which is always present, may vary in its intensity. The simulation of the desired deficiency and self-mutilation are some practices performed by those who do not sustain the anguish of this desire. In this context, the demand for blindness, deafness and paralysis should also be addressed. When representing a not-normal body, these individuals question and challenge the definitions of autonomy, normalcy, bodily integrity, disability and disability

Humans , Self Mutilation , Mental Health , Body Modification, Non-Therapeutic , Body Dysmorphic Disorders , Amputation
Article in Korean | WPRIM | ID: wpr-787400


OBJECTIVES: The purpose of this study was to investigate the effect of body dissatisfaction on Smartphone addiction and to determine the relative magnitudes of specific mediation effect of personality characteristics.METHODS: One hundred and fifteen young and healthy participants completed the Smartphone Addiction Scale, Body Dysmorphic Disorder Examination-Self Report, and NEO Five-Factor Inventory. By using Indirect SPSS macros, multiple-mediation analyses were performed.RESULTS: Body dissatisfaction had a significant total, direct and indirect effect on Smartphone addiction. Indirect effect of Body dissatisfaction on Smartphone addiction was significantly mediated via personality characteristics (Neuroticism, Conscientiousness, and Openness).CONCLUSION: These results suggest the importance of evaluating both patients' personality characteristics and body dissatisfaction for managing Smartphone addiction. Consequently, they will be useful in the prevention and treatment of Smartphone addiction.

Body Dysmorphic Disorders , Healthy Volunteers , Negotiating , Smartphone
Bol. méd. postgrado ; 34(1): 19-25, Ene-Jun. 2018. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1121143


El Síndrome del Anillo del Cromosoma 18 (18 [(r)18]) es un trastorno cromosómico que se incluye dentro de las anomalías estructurales desequilibradas donde dicho cromosoma se encuentra en forma de anillo el cual resulta de la pérdida simultánea de ambos segmentos terminales de los brazos corto y largo con la subsecuente fusión de sus extremos, constituyendo una estructura circular que microscópicamente se asemeja a un anillo, de allí su nomenclatura r (del inglés ring, que significa anillo). Tiene una incidencia de 1/40.000 nacidos vivos y hasta la fecha se han reportado aproximadamente entre 80 a 100 casos a nivel mundial sin embargo sólo existen alrededor de nueve reportes de r(18) en mosaico, aislado o asociado con otras alteraciones cromosómicas. A continuación, se presenta el caso de una paciente pediátrica con Síndrome del Anillo del cromosoma 18 estudiado y diagnosticado en la Unidad de Genética Médica de la Universidad Centroccidental Lisandro Alvarado en Barquisimeto, Venezuela, con la correspondiente revisión de la literatura relacionada con este síndrome(AU)

Chromosome 18 Ring Syndrome (18 [(r) 18]) is a chromosomal disorder that is included among the unbalanced structural anomalies in which chromosome 18 has a ring form which results from the simultaneous loss of both terminal segments of the short and long arms with the subsequent fusion of their ends forming a circular structure that microscopically resembles a ring, hence its nomenclature r (of the English ring, which means ring).18r Syndrome has an incidence of 1/40,000 live births; to date approximately 80-100 cases worldwide have been reported. There are only about nine reports of r(18) in mosaic, isolated or associated with other chromosomal alterations. We present a case of a pediatric patient with Chromosome 18 Ring Syndrome, evaluated and diagnosed in the Unidad de Genética Médica of the Universidad Centroccidental Lisandro Alvarado in Barquisimeto, Venezuela with the corresponding review of the literature(AU)

Humans , Female , Child, Preschool , Ring Chromosomes , Chromosomes, Human, Pair 18 , Cellular Structures , Body Dysmorphic Disorders , Pediatrics , Karyotype , Genetics
Rev. colomb. psiquiatr ; 47(2): 98-107, abr.-jun. 2018. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-960176


RESUMEN Introducción: Para facilitar la toma de decisiones clínicas, están proliferando las guías de práctica clínica (GPC). Sin embargo, actualmente se carece de GPC para el trastorno obsesivo compulsivo (TOC) en las que se incluyan los requerimientos y las expectativas de los usuarios. Objetivos: El objetivo del presente trabajo es conocer si las recomendaciones de la guía «Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder¼ del National Institute for Clinical Excellence (NICE) se corresponden con las necesidades y preferencias de un grupo de usuarios diagnosticados de TOC. Métodos: Para ello, se conformaron 2 grupos focales con un total de 12 pacientes, a los que se preguntó sobre el impacto del TOC en sus vidas, su experiencia con los servicios de salud mental, la satisfacción con los tratamientos recibidos y los recursos personales de afrontamiento. Las preferencias y necesidades de los usuarios se compararon con las recomendaciones de la guía y, para facilitar su accesibilidad, se agruparon en 4 grandes áreas temáticas: información, accesibilidad, abordaje terapéutico y relación terapéutica. Resultados: Se observó una alta correspondencia entre las recomendaciones y las preferencias de los usuarios; por ejemplo, respecto a las intervenciones psicológicas de alta intensidad. La escasez de intervenciones psicológicas de baja intensidad antes de acudir al servicio de salud mental o la dificultad para acceder a los profesionales son algunas de las experiencias narradas que discreparon con las recomendaciones de la guía y de las necesidades expresadas por este grupo de usuarios. Conclusiones: Hay coincidencia entre las recomendaciones y las preferencias y necesidades de los usuarios; sin embargo, los servicios sanitarios responden a ellas parcialmente.

ABSTRACT Introduction: The number of Clinical Practice Guidelines (CPG) to help in making clinical decisions is increasing. However, there is currently a lack of CPG for Obsessive-Compulsive Disorder that take into account the requirements and expectations of the patients. Objective: The aim of the present study was to determine whether recommendations of the NICE guideline, "Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder" agrees with the needs and preferences of patients diagnosed with OCD in the mental health service. Material and method: Two focal groups were formed with a total of 12 participants. They were asked about the impact of the disorder in their lives, their experiences with the mental health services, their satisfaction with treatments, and about their psychological resources. Preferences and needs were compared with the recommendations of the guidelines, and to facilitate their analysis, they were classified into four topics: information, accessibility, treatments, and therapeutic relationship. Results: The results showed a high agreement between recommendations and patients preferences, particularly as regards high-intensity psychological interventions. Some discrepancies included the lack of prior low-intensity psychological interventions in mental health service, and the difficulty of rapid access the professionals. Conclusions: There is significant concordance between recommendations and patients preferences and demands, which are only partially responded to by the health services.

Humans , Male , Female , Adult , Middle Aged , Health Services Needs and Demand , Mental Health Services , Adaptation, Psychological , Practice Guideline , Focus Groups , Body Dysmorphic Disorders , Clinical Decision-Making , Health Services , Methods , Obsessive-Compulsive Disorder
Iatreia ; 31(1): 93-96, ene.-mar. 2018. graf
Article in Spanish | LILACS | ID: biblio-892691


RESUMEN Los recién nacidos con complicaciones durante el parto, prematuridad o malformaciones congénitas pueden ser de riesgo cuando requieren intubación orotraqueal. Presentamos el caso de una recién nacida a término con un síndrome dismórfico, atendida en un hospital de segundo nivel en Bogotá, quien requirió intubación orotraqueal por episodios de apnea y cianosis que se presentaron a las cinco horas de nacida, mientras se encontraba en la cama con su madre. Después de múltiples intentos de intubación orotraqueal presentó sangrado cuya procedencia no fue fácil de identificar; finalmente, el anestesiólogo logró asegurar la vía aérea con una máscara laríngea. Fue remitida a nuestra institución, donde se le hizo panendoscopia en la que se evidenció una lesión penetrante de tres centímetros de profundidad en la vallécula derecha. Presentamos la evaluación, el tratamiento, las alternativas del mismo y la evolución de la paciente.

SUMMARY Infants with complications during labor, prematurity, or birth defects may be at risk when they require orotracheal intubation. We report the case of a full-term female infant with a dysmorphic syndrome, seen at a second level hospital in Bogotá, who required orotracheal intubation due to episodes of apnea and cyanosis 5 hours after birth, while she was in bed with her mother. After multiple attempts at orotracheal intubation, there was bleeding from a difficult-to-identify source. Finally, the anesthesiologist secured the airway with a laryngeal mask. She was referred to our institution where a panendoscopy revealed a penetrating lesion, three centimeters in depth, at the right vallecular. We present the assessment, the treatment, its alternatives and the evolution of the patient.

Humans , Female , Infant, Newborn , Wounds and Injuries , Airway Management , Intubation , Body Dysmorphic Disorders
Rev. bras. cir. plást ; 32(4): 586-593, out.-dez. 2017. tab
Article in English, Portuguese | LILACS | ID: biblio-878787


Transtornos psiquiátricos são amplamente evidenciados em pacientes que buscam tratamentos estéticos. Apesar de não configurarem necessariamente uma contraindicação para a realização de procedimentos, o reconhecimento desses sintomas pelo profissional tende a contribuir para o fortalecimento da relação profissional-paciente e para um melhor prognóstico, reduzindo as chances de insatisfação, complicações e agravos nos sintomas psiquiátricos, além de evitar complicações legais. No presente artigo, os transtornos psiquiátricos mais comuns no domínio cosmético e estético foram apresentados e discutidos, assim como as orientações para o reconhecimento de sintomas e de manuseio destes pacientes por profissionais de saúde.

Psychiatric disorders are widely reported in patients seeking aesthetic treatments. Although they are not necessarily a contraindication for procedures, the recognition of these symptoms by the professional tends to strengthen the professional-patient relationship, thus leading to a better prognosis. This reduces the chances of dissatisfaction, complications, and aggravation of psychiatric symptoms, in addition to avoiding legal complications. In this article, the most common psychiatric disorders arising in cosmetic and aesthetic treatment are presented and discussed, as well as guidelines for recognizing the symptoms and managing these patients.

Humans , History, 21st Century , Psychiatry , Surgery, Plastic , Feeding and Eating Disorders , Mental Health , Esthetics , Body Dysmorphic Disorders , Dissociative Identity Disorder , Psychiatry/methods , Psychiatry/standards , Surgery, Plastic/methods , Surgery, Plastic/rehabilitation , Feeding and Eating Disorders/complications , Feeding and Eating Disorders/therapy , Mental Health/standards , Mental Health/ethics , Esthetics/psychology , Body Dysmorphic Disorders/complications , Body Dysmorphic Disorders/therapy , Dissociative Identity Disorder/therapy
Rev. bras. cir. plást ; 32(3): 428-434, jul.-set. 2017.
Article in English, Portuguese | LILACS | ID: biblio-868294


Este estudo objetivou verificar, por meio de uma revisão sistemática da literatura e da realização de uma meta-análise, a prevalência do transtorno dismórfico corporal em pacientes candidatos e/ou submetidos a procedimentos estéticos na especialidade da Cirurgia Plástica. Para cumprir com o objetivo proposto, foram analisados os mais relevantes estudos publicados originalmente em qualquer idioma, porém, que estivessem indexados às bases de dados National Library of Medicine (MEDLINE), Cochrane e Scielo, nas quais as buscas foram realizadas, por meio do uso de descritores associados ao tema e de critérios de inclusão e exclusão. Sendo assim, a amostra final deste estudo foi composta por 15 publicações, as quais foram submetidas a uma meta-análise, podendo-se verificar que 12,5% dos pacientes que são candidatos/submetidos a procedimentos estéticos na especialidade da Cirurgia Plástica possuem transtorno dismórfico corporal. Destes, a maioria é do gênero feminino (75,7%) e possui média de idade de 30 (± 10,5) anos. Devido ao alto índice de pacientes com transtorno dismórfico corporal atendidos na especialidade, ressalta-se a importância de os cirurgiões plásticos atentarem-se para o adequado atendimento dos pacientes, com vistas à identificação dos indivíduos potencialmente portadores desse transtorno e, consequentemente, à solicitação de um acompanhamento interdisciplinar com a participação de psicólogos e psiquiatras.

This study aimed at showing the prevalence of body dysmorphic disorder (BDD) in patients who are candidates and/or are submitted to aesthetic procedures in the specialty of plastic surgery via a systematic review of the literature and a meta-analysis. To comply with the proposed objective, we analyzed the most relevant studies originally published in any language that were available in the National Library of Medicine (MEDLINE), Cochrane, and SciELO databases. Searches were performed using keywords associated with the theme and inclusion and exclusion criteria. Thus, the final sample of this study was composed of 15 publications, which were submitted to a meta-analysis. It can be confirmed that 12.5% of the patients who were candidates/submitted to aesthetic procedures in the specialty of plastic surgery had BDD. Of these, the majority were women (75.7%) with a mean age of 30 (± 10.5) years. Given the high number of patients with BDD attended to in the specialty, it is important that plastic surgeons focus on providing patients with adequate care to identify individuals who potentially have BDD and consequently conduct an interdisciplinary follow-up with the participation of psychologists and psychiatrists.

Humans , History, 21st Century , Surgery, Plastic , Esthetics , Body Dysmorphic Disorders , Systematic Review , Mental Disorders , Body Dysmorphic Disorders/pathology , Mental Disorders/pathology
Article in English | WPRIM | ID: wpr-41573


Steroid withdrawal syndrome (SWS) following steroid dependence is becoming a common clinical condition. It may be associated with body image disorder. Though selective serotonin reuptake inhibitors (SSRIs) are found to be effective SWS associated depression, data for this clinical condition is limited. We present a case of SWS associated with body image disorder which improved with mirtazapine. Mirtazapine might be better option than SSRIs in this subgroup of patients for its noradrenergic property and better gastrointestinal profile. More research should explore its efficacy in this clinical condition.

Body Dysmorphic Disorders , Depression , Humans , Serotonin Uptake Inhibitors
Rev. bras. cir. plást ; 32(1): 135-140, 2017.
Article in English, Portuguese | LILACS | ID: biblio-832688


O objetivo da pesquisa foi realizar uma revisão de literatura de estudos relacionados à Cirurgia Plástica Estética. Dessa forma, foram analisadas as pesquisas desenvolvidas com a amostra em questão. As buscas foram feitas nas bases de dados Scopus, PubMed e Medline. Foram utilizados os seguintes descritores: "cosmetic surgery", "body dysmorphic disorder" e "eating disorders". Os dados foram sintetizados em três tópicos: "Perfil do paciente e aspectos motivacionais", "Transtorno Dismórfico Corporal e Cirurgia Plástica" e "Transtornos Alimentares e Cirurgia Plástica". Conclui-se que o motivo principal para realização da cirurgia plástica estética é a insatisfação com o corpo. Além disso, o Transtorno Dismórfico Corporal possui alta prevalência nesses indivíduos. Ademais, mesmo após a realização do procedimento, esses sujeitos encontram-se insatisfeitos com seus corpos. As cirurgias plásticas mais comuns entre os pacientes com Transtornos Alimentares são o implante de silicone nas mamas e lipoaspiração de abdômen. Pela revisão de literatura pode-se perceber a necessidade dos profissionais da área de saúde terem acesso às informações referentes a esse grupo de indivíduos.

The aim of this study was to conduct a literature review of studies related to esthetic plastic surgery. Thus, studies conducted on this topic were searched. The searches were performed on the Scopus, PubMed, and Medline databases. The following keywords were used: "cosmetic surgery," "body dysmorphic disorder," and "eating disorders." The data were summarized in three topics: "profile of patients and motivational aspects," "plastic surgery and body dysmorphic disorder," and "plastic surgery and eating disorders." We conclude that the main reason for undergoing esthetic plastic surgery is dissatisfaction with the body . In addition, body dysmorphic disorder has a high prevalence in these individuals. Moreover, even after the completion of the surgery, these individuals are still dissatisfied with their bodies . The most common plastic surgeries among patients with eating disorders are silicone breast implantation and liposuction of the abdomen. From the literature review, we can perceive the need for health care professionals to have access to information regarding this group of individuals.

Humans , Male , Female , History, 21st Century , Patients , Social Behavior , Body Image , Review Literature as Topic , Feeding and Eating Disorders , Patient Satisfaction , Reconstructive Surgical Procedures , Body Dysmorphic Disorders , Body Image/psychology , Feeding and Eating Disorders/pathology , Feeding and Eating Disorders/psychology , Reconstructive Surgical Procedures/methods , Reconstructive Surgical Procedures/psychology , Reconstructive Surgical Procedures/ethics , Body Dysmorphic Disorders/surgery , Body Dysmorphic Disorders/psychology
Säo Paulo med. j ; 134(6): 480-490, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-846261


ABSTRACT: CONTEXT AND OBJECTIVE: Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. METHODS: Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. RESULTS: The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001) and intra-rater reproducibility (ICC = 0.939; P < 0.001). Significant differences in total scores were found between patients with and without symptoms (P < 0.001). A strong correlation (r = 0.841; P < 0.001) was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. CONCLUSIONS: The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.

RESUMO CONTEXTO E OBJETIVO: Rinoplastia é uma das operações mais procuradas por indivíduos com o transtorno dismórfico corporal. O objetivo deste estudo foi adaptar culturalmente e validar a Body Dysmorphic Symptoms Scale. DESENHO E LOCAL: Estudo de validação cultural desenvolvido no ambulatório de cirurgia plástica de um hospital universitário público. MÉTODOS: Oitenta pacientes consecutivos de ambos os gêneros que desejavam submeter-se à rinoplastia foram selecionados entre fevereiro de 2014 e março de 2015. Trinta pacientes participaram da fase de adaptação cultural do instrumento. A reprodutibilidade foi testada em 20 pacientes e a validade de construto em 50 pacientes, correlacionando-se a escala com a Yale-Brown Obsessive Compulsive Scale para transtorno dismórfico corporal. RESULTADOS: A versão brasileira do instrumento mostrou alfa de Cronbach de 0,805 e excelente reprodutibilidade interobservador (coeficiente de correlação intraclasse, CCI = 0,873; P < 0,001) e intraobservador (CCI = 0,939; P < 0,001). Houve diferença significante entre os escores totais de pacientes com e sem sintomas (P < 0,001). Observou-se forte correlação (r = 0,841; P < 0,001) entre a Yale-Brown Obsessive Compulsive Scale para transtorno dismórfico corporal e a Body Dysmorphic Symptoms Scale. A área sob a curva característica de operação do receptor (ROC) foi de 0,981, revelando boa acurácia para discriminar a presença de sintomas para transtorno dismórfico corporal; 46% dos pacientes apresentaram sintomas do transtorno dismórfico corporal e 54% dos pacientes apresentaram sintomas obsessivo-compulsivos moderados a graves relacionados com a aparência. CONCLUSÃO: A versão brasileira da Body Dysmorphic Symptoms Scale é um instrumento reprodutível que apresenta validade de face, conteúdo e construto.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Rhinoplasty/psychology , Translations , Body Dysmorphic Disorders/diagnosis , Self Report/standards , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales , Psychometrics , Severity of Illness Index , Brazil , Observer Variation , Cross-Cultural Comparison , Reproducibility of Results , Sensitivity and Specificity , Patient Satisfaction , Cultural Characteristics , Body Dysmorphic Disorders/psychology , Obsessive-Compulsive Disorder/psychology
Aletheia ; 49(2): 20-29, jul.-dez. 2016.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-916038


O objetivo deste estudo foi investigar a relação do narcisismo com manifestações atuais de sofrimento relacionadas com a identidade e a imagem através das alterações no corpo. Foi exposta a existência do papel da cultura contemporânea nessa dinâmica, mas considerou-se principalmente a importância de questionar a constituição psíquica de cada sujeito e de que maneira ele comunica o seu sofrimento através das ofertas que a cultura faz. Como referencial teórico, utilizou-se a psicanálise freudiana e artigos que trabalham a vigorexia. Como metodologia, apresentaram-se recortes do discurso de participantes de um documentário sobre o fisiculturismo. Notou-se a importância da sensibilidade na escuta desses sujeitos que nem sempre nos comunicam seu padecer através do discurso, senão por atos ­ atos que podem camuflar-se nos discursos e nas normas que a nossa cultura estabelece.(AU)

This study aims to observe the relation between narcissism and identity and image suffering related to body modifications. Here, it was uncovered the role of contemporary culture in this dynamics, also considering the importance of questioning the psychical constitution of each subject, and how they communicate the inner suffering by means of the offers that culture does. Freudian psychoanalysis papers and studies related to Muscle dysmorphia was used as bibliographical reference, and clippings of bodybuilding documentary with participants' speeches was presented as case reports. It was observed the importance of being sensitive in listening these subjects, that most part of the time are unable to report their suffering by their discourse, but, by acts that can camouflage themselves in speeches and standards that our culture establishes.(AU)

Humans , Self Concept , Body Image , Narcissism , Body Dysmorphic Disorders , Physical Appearance, Body