A study quantifying body dysmorphophobia in patients with cosmetic concerns visiting a dermatology clinic

Objectives Body dysmorphic disorder (BDD) is a commonly encountered condition in the practice of cosmetic dermatology that is often unidentified. Recognition of BDD is important while assessing a patient for an esthetic procedure. While a few studies have been performed previously to screen patients for BDD, this study was performed to quantify and compare the extent of BDD in patients attending dermatology clinics with cosmetic concerns. Material and Methods A descriptive cross-sectional observational study was conducted over a period of 1 month on 100 patients visiting a private dermatological esthetic clinic. The patients presenting with cosmetic concerns were taken as cases, while those with non-cosmetic concerns were taken as controls. Both groups were evaluated for BDD using the BDD-Yale-brown obsessive-compulsive scale (YBOCS) questionnaire. Results The overall prevalence of BDD in our study was found to be 7.2%, which is 3 times the prevalence in the general population. About 62.58% ( n = 44) of the cases suffered from BDD with a mean BDD-YBOCS score of 12.586 in contrast to 33.33% of controls ( n = 10) with a mean score of 5.56 ( P < 0.05, P < 0.05). Of these cases with BDD, 43% suffered from mild, 32% from moderate, 14% from severe, and 11% from extreme symptoms. BDD prevalence and score were found to be higher in younger patients and females ( P < 0.05). There was no statistically significant difference in the BDD scores with regard to education, employment, marital status, the nature of concern (skin or hair), or the nature of treatment offered (procedural or non-procedural). Conclusion BDD is seen in a higher proportion of patients with cosmetic concerns, with 25% having severe BDD. Screening and quantification of BDD using the BDD-YBOCS questionnaire must be undertaken, especially in patients with cosmetic concerns. Patients with severe BDD require proper counseling and may need a psychiatric referral before an esthetic procedure.