The psychological assessment of patients requesting orthognathic treatment is a vital and integral part of the overall assessment procedure. It allows identification of potential problems at an early stage before irreversible decisions have been made.
This paper aims to highlight some of the aspects of psychological assessment which are particularly important. It also discusses current concepts in the diagnosis and treatment of those patients suffering from body dysmorphic disorder (BDD). This is the term applied to those individuals with a normal appearance who present requesting treatment because they believe that they have a ‘defect’.
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References
1.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, DSM-IV, 4TH EDN, American Psychiatric Press Inc, Washington DC, pp. 466–469.
2.
EdgertonM. T. and KnorrN. J. (1971) Motivational patterns of patients seeking cosmetic (aesthetic) surgery, Plastic and Reconstructive Surgery, 48, 551–557.
3.
GoodacreT. E. E. and MayouR. (1995) Dysmorphophobia in plastic surgery and its treatment, In: MayouR., BassC. and SharpeM. (eds) Treatment of Functional Somatic Symptoms. Oxford University Press, Oxford, pp. 231-251.
4.
HarrisD. L. (1989) Cosmetic surgery, Annals of the Royal College of Surgeons of England, 71, 195–199.
5.
HollanderE., LiebowitzM. R., WinchelR., KlumkerA. and KleinD. F. (1989) Treatment of body dysmorphic disorder with serotonin reuptake blockers, American Journal of Psychiatry, 146. 768–770.
6.
LewisC. M., LavellS. and SimpsonM. F. (1983) Patient selection and patient satisfaction. Clinics in Plastic Surgery, 10, 321–332.
7.
MarksI. M. and MishanJ. (1988) Dysmorphophobic avoidance with disturbed bodily perception, British Journal of Psychiatry, 152, 674–678.
8.
MunroA. and StewartM. (1991) Body dysmorphic disorder and the DSM-IV: the demise of dysmorphophobia, Canadian Journal of Psychiatry, 36, 91–96.
9.
PerugiG., GiannottiD., FrareF., Di VaioS., ValoriE., MaggiL., CassanoG. B. and AkiskalH. S. (1997) Prevalence, phenomenology and comorbidity of body dysmorphic disorder (dysmorphophobia) in a clinical population, International Journal of Psychiatry in Clinical Practice, 1, 77–82.
10.
PetersonL. J. and TopazianR. G. (1976) Psychological considerations in corrective maxillary and midfacial surgery, Journal of Oral Surgery, 34, 157–164.
11.
PhillipsK. A. (1991) Body Dysmorphic Disorder: the distress of imagined ugliness. American Journal of Psychiatry, 148, 1138–1149.
12.
PhillipsK. A., McElroyS. L., KeckP. E., PopeH. G. and HudsonJ. I. (1993) Body Dysmorphic Disorder: 30 cases of imagined ugliness. American Journal of Psychiatry150. 302–308.
13.
PhillipsK. A., McElroyS. L., KeckP. E., HudsonJ. I. and PopeH. G. (1994) A comparison of delusional and non-delusional Body Dysmorphic Disorder in 100 cases, Psychopharmacology Bulletin, 30, 179–186.
14.
PhillipsK. A., McElroyS. L., HudsonJ. I. and PopeH. G. (1995) Body Dysmorphic Disorder: an obsessive-compulsive spectrum disorder, a form of affective spectrum disorder, or both?Journal of Clinical Psychiatry, 56 (Suppl 4), 41–51.
15.
ReichJ. (1975) Factors influencing patient satisfaction with the results of aesthetic plastic surgery, Plastic and Reconstructive Surgery55, 5–13.
16.
RosenJ. C. and ReiterJ. (1996) Development of the Body Dysmorphic Disorder examination, Behaviour Research and Therapy, 34, 755–766
17.
RosenJ. C., ReiterJ. and OrosanP. (1995) Cognitive-behavioral body image therapy for Body Dysmorphic Disorder, Journal of Consulting and Clinical Psychology, 63, 263–269.
18.
ThomasC. S. (1984) Dysmoi phophobia: a question of definition, British Journal of Psychiatry, 144, 513–516.
19.
ThomasC. S. (1995) A study of facial dysmorphophobia. Psychiatric Bulletin, 19, 736–739.
20.
VealeD., BoocockA., GournayK., DrydenW., ShahF., WillsonR. and WalburnJ. (1996) Body Dysmorphic Disorder; a survey of fifty cases, British Journal of Psychiatry, 169. 196–201.
21.
World Health Organization (1992) ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines, World Health Organization Section F45.2, Geneva, pp. 164-166.
22.
ZigmondA. S. and SnaithR. P. (1983) The Hospital Anxiety and Depression Scale, Acta Psychiatrica Scandinavica, 67, 361–370.
