Persons with body dysmorphic disorder (BDD) frequently seek surgical and minimally invasive (MI) treatments to improve their appearance, but few studies have evaluated patient characteristics and outcomes. Surgical/MI treatment histories of 200 persons with BDD were cross-sectionally/retrospectively evaluated. Clinical and demographic characteristics of persons who received such treatments (n = 42) were compared to those who had not (n = 158). Outcomes and reasons for nonreceipt of requested procedures were examined. Receivers of surgical/MI treatments reported less severe current BDD symptoms and delusionality than persons who did not receive such treatments. Surgical/MI treatments were more likely than other cosmetic procedures to decrease preoccupation with the treated body part; however, overall BDD severity improved with only 2.3% of treatments. Cost and physician refusal were the most common reasons requested treatment was not received. However, physicians were more likely to provide requested surgical/MI treatment than other types of requested cosmetic treatment, despite the poor longer-term outcome.
From the *Department of Psychology and Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA; †Butler Hospital, Alpert Medical School of Brown University, Providence, RI; and ‡The Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.
Received March 12, 2009 and accepted for publication, after revision, August 10, 2009.
Supported by Award Number R01MH060241 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.
Reprints: Katharine A. Phillips, MD, Butler Hospital, Alpert Medical School of Brown University, 345 Blackstone Blvd, Providence, RI 02906. E-mail: Katharine_Phillips@brown.edu.