Transtorno dismórfico corporal: prevalência em pacientes submetidos a cirurgias plásticas no Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ)

Abstract

Body dysmorphic disorder (BDD) is characterized by excessive preoccupation with minor or imagined physical defects, resulting in significant distress and psychosocial impairment, and its prevalence among plastic surgery patients can reach values up to 15 times higher than in the general population. This study, conducted at the Clementino Fraga Filho University Hospital of the Federal University of Rio de Janeiro, aimed to calculate the prevalence of BDD in patients undergoing aesthetic plastic surgery and highlight the relevance of the disorder in the specialty. The Brazilian version of the Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) was used to identify symptoms. The sample included 77 patients, 86% female. It was found that 72% presented mild to moderate symptoms and 28% severe symptoms. Among the patients, 56% spent more than 3 hours a day thinking about body defects, and 96% reported significant distress regarding appearance. The highest prevalence was observed in abdominoplasty (67%), followed by fat grafting in the face (55%). The prevalence found is consistent with some previous studies, but varies in relation to others. The discussion highlights the importance of screening for BDD before cosmetic surgery, recommending that plastic surgeons perform psychological evaluations to identify patients with the disorder and refer them, when necessary, for appropriate treatment. The presence of BDD is not an absolute contraindication for surgery, but it should be carefully considered. Surgeons' training should include psychodynamic aspects to improve understanding of the psychological impacts of cosmetic surgery and avoid legal disputes. Detailed documentation and informed consent are essential to protect the professional.