Should all cosmetic patients be screened for BDD?

Body Dysmorphic Disorder (BDD) consists of a preoccupation with an imagined defect in one's appearance or where a mild physical anomaly elicits concern anddistress that is out of proportion to the problem. The patient with BDD may focus on any part of the body or on multiple aspects of one's appearance. The prevalence of this disorder is as high as 15% in cosmetic and dermatologic settings.

Cosmetic procedures and treatments generally yield poor outcomes for patients with BDD in terms of satisfaction. Occasionally, the BDD patient may be partly satisfied by a cosmetic procedure or become less satisfied over time post surgery. In general, however, patients with BDD very often remain preoccupied and distressed about the same or different perceived defect. It is therefore very important for patients with BDD to be identified so that appropriate further assessment and advice can be given (in place of being offered surgery or cosmetic treatment forthright).

In order to address this important issue and in accordance with British Association of Aesthetic Plastic Surgery guidelines(BAAPS), we at CC Kat Aesthetics will be including a screening questionnaire for all new patients seen at our clinic and at the three hospitals where I work. The Cosmetic Procedure Screening Questionnaire has been developed by Dr D Veale and Co at the Centre for Anxiety Disorders and Trauma, Institute of Psychiatry, London for the specific use in cosmetic settings. We are very grateful to his team for their generosity in making the questionnaire available.

Do you agree or do you think this is an infringement of your personal choice?

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