Body dysmorphic disorder in patients undergoing orthognathic surgery: associations and applicability of screening...

The study aimed to evaluate the prevalence and associations of body dysmorphic disorder (BDD) in East Asian patients undergoing orthognathic surgery, and the applicability of current BDD screening tools for these patients. A prospective cohort study was conducted involving patients presenting for orthognathic surgery. Data on their preoperative and postoperative complaints, age, gender, psychiatric history, skeletal classification, overjet and overbite were collected. Patients completed three questionnaires as part of their BDD screening: Body Dysmorphic Disorder Questionnaire (BDDQ), Appearance Anxiety Inventory (AAI), and Oral Health Impact Profile-14 (OHIP-14). Patients screening positive were referred for formal psychiatric diagnosis. Analyses were conducted to evaluate for associations between clinical variables and a positive or negative BDD screen. One hundred patients were included in the study, of whom 10% screened positive with the BDDQ. A positive screen was associated with female sex (P < 0.0001) and patients with higher AAI scores (P < 0.0001). No significant associations were found between a positive screen and age, psychiatric history, skeletal relationship, overjet, overbite, or OHIP-14 scores. Of the patients referred for formal psychiatric evaluation, none was ultimately diagnosed with BDD. No postoperative aesthetic complaints were reported. The BDDQ yielded a positive screen of 10% in this study, with only sex being significantly associated with a positive screen. While BDD screening tools may identify patients with a heightened sense of aesthetics, the applicability of these tools in this population is limited, as none of the patients who screened BDD positive were ultimately diagnosed with BDD.