The Body Dysmorphic Symptoms Scale: Translation into Brazilian Portuguese, cultural adaptation and validation

INTRODUCTION: Rhinoplasty is one of the most sought after aesthetic surgeries by individuals with body dysmorphic disorder (BDD), which is characterized by an excessive dissatisfaction with appearance that may affect patient satisfaction with the results of surgery. OBJECTIVE: To translate into Brazilian Portuguese, cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale (BDSS). METHODS: Eighty patients of both genders seeking rhinoplasty were selected at the Nose Outpatient Clinic (Division of Plastic Surgery, Federal University of São Paulo) between February 2014 and March 2015. Thirty patients participated in the cross-cultural adaptation phase. The instrument was tested for reliability in 20 patients and for construct validity in 50 patients by correlating the BDSS with the Brazilian version of the Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS). RESULTS: Internal consistency was tested using Cronbach's alpha coefficient (?=0.805). The BDSS showed excellent interobserver (r=0.909; ICC=0.873; p<0.001) and intraobserver (r=0.956; ICC=0.939; p<0.001) reliability. There was a significant difference in BDSS scores between patients with and without BDD symptoms (p<0.001), and a strong correlation (r=0.841; p<0.001) between BDD-YBOCS and BDSS scores. The area under the receiver operating characteristic (ROC) curve was 0.981, indicating good accuracy to discriminate the presence of BDD symptoms. Forty-six percent of patients had BDD symptoms (BDSS) and 54% presented moderate to severe appearance-related obsessive- compulsive symptoms (BDD-YBOCS). CONCLUSION: The cross-culturally adapted Brazilian version of the BDSS is a reliable instrument with face, content, and construct validity; it was named Body Dysmorphic Symptoms Scale-UNIFESP/EPM (BDSS-UNIFESP/EPM).Introdução: A rinoplastia é uma das operações mais procuradas por indivíduos com o transtorno dismórfico corporal (TDC), caracterizado por uma insatisfação excessiva com a aparência que pode afetar os resultados de satisfação em Cirurgia Plástica. Objetivo: Traduzir para a língua portuguesa, adaptar culturalmente e validar a Body Dysmorphic Symptoms Scale (BDSS). Métodos: Oitenta pacientes de ambos os gêneros, que desejavam submeter-se à rinoplastia, foram selecionados no Ambulatório de Cirurgia Nasal da Disciplina de Cirurgia Plástica da Universidade Federal de São Paulo, entre Fevereiro de 2014 e Março de 2015. Trinta pacientes participaram da fase de adaptação cultural. A reprodutibilidade foi testada em 20 pacientes e a validade de construto em 50 pacientes [correlação entre a BDSS e a Versão Brasileira da Yale Brown Obsessive Compulsive Scale Modificada para Transtorno Dismórfico Corporal (BDD- YBOCS)]. Resultados: A consistência interna foi testada pelo alfa de Cronbach (0,805). A BDSS apresentou excelente reprodutibilidade interobservador (r=0,909; CCI=0,873; p<0,001) e intraobservador (r=0,956; CCI=0,939; p<0,001). Houve diferença entre pacientes com e sem sintomas (p<0,001) (BDSS). Observou-se forte correlação (r=0,841; p<0,001) entre BDD-YBOCS e BDSS. A área sob a curva ROC foi de 0,981, revelando boa acurácia para discriminar a presença de sintomas do TDC. Quarenta e seis por cento dos pacientes apresentaram sintomas para TDC (BDSS) e em 54% dos pacientes identificaram-se sintomas obsessivo- compulsivos moderados a graves com a aparência (BDD-YBOCS). Conclusão: A BDSS foi traduzida para a língua portuguesa, do Brasil, adaptada culturalmente, e mostrou-se reprodutível, apresentando validades Resumo de face, conteúdo e construto, sendo denominada Escala de Sintomas da Dismorfia Corporal-UNIFESP/EPM (BDSS-UNIFESP/EPM).Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: cross-cultural validation study

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

Prevalence of Body Dysmorphic Disorder Symptoms and Body Weight Concerns in Patients Seeking Abdominoplasty

Body dysmorphic disorder (BDD) is one of the most common psychiatric conditions found in patients seeking cosmetic surgery, and body contouring surgery is most frequently sought by patients with BDD. To estimate the prevalence and severity of BDD symptoms in patients seeking abdominoplasty. Ninety patients of both sexes were preoperatively divided into two groups: patients with BDD symptoms (n = 51) and those without BDD symptoms (n = 39) based both on the Body Dysmorphic Disorder Examination (BDDE) and clinical assessment. Patients in the BDD group were classified as having mild to moderate or severe symptoms, according to the BDDE. Body weight and shape concerns were assessed using the Body Shape Questionnaire (BSQ). The prevalence of BDD symptoms was 57%. There were significant associations between BDD symptoms and degree of body dissatisfaction, level of preoccupation with physical appearance, and avoidance behaviors. Mild to moderate and severe symptoms of BDD were present in 41% and 59% of patients, respectively, in the BDD group. It was found that the more severe the symptoms of BDD, the higher the level of concern with body weight and shape (P < .001). Patients having distorted self-perception of body shape, or distorted comparative perception of body image were respectively 3.67 or 5.93 times more likely to show more severe symptoms of BDD than those with a more accurate perception. Candidates for abdominoplasty had a high prevalence of BDD symptoms, and body weight and shape concerns were associated with increased symptom severity.Univ Vale Sapucai, Coll Hlth Sci, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, Div Plast Surg, Dept Surg, BR-0402400 Sao Paulo, BrazilUniv Sao Paulo, Dept Psychiat, Sao Paulo, BrazilUniv Minho, Inst Social Sci, Guimaraes, PortugalUniv Fed Sao Paulo, Grad Program Translat Surg, BR-0402400 Sao Paulo, BrazilUniv Fed Sao Paulo, Paulista Sch Med, BR-0402400 Sao Paulo, BrazilUniv Fed Sao Paulo, Div Plast Surg, Dept Surg, BR-0402400 Sao Paulo, BrazilUniv Fed Sao Paulo, Grad Program Translat Surg, BR-0402400 Sao Paulo, BrazilUniv Fed Sao Paulo, Paulista Sch Med, BR-0402400 Sao Paulo, BrazilWeb of Scienc