Document Type : Original Article


1 Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Orthodontic Assistant, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Orthodontics Assistant, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.


Aim: BDD is a psychiatric diagnosis in the spectrum of obsessive compulsive disorder wherein the patient has a damaging mental preoccupation with a slight deficiency in his physical appearance. Awareness of this disease and its symptoms is essential for proper diagnosis and management of the patient.
Methods: This cross-sectional study was performed on 86 patients who underwent orthognathic surgery. A demographic information questionnaire, Yale-Brown Obsessive Compulsive Scale modified for the BDD questionnaire, BDI-II questionnaire (Depression Scale) and Beck Anxiety Scale questionnaire were completed by patients to assess BDD disorder, depression, and anxiety. Data were described using appropriate statistical tables and graphs to express indicators and frequency distribution. Shapiro-Wilk, Mann-Whitney, Kruskal-Wallis, and Fisher tests were used to analyze the data.
Results: This study was performed on 86 patients with a mean age of 23.19±4.5 years. The percentage of BDD in women (20%) was higher than in men (14%), but this difference was not statistically significant (p=0.685). The prevalence of depression was significantly higher (p<0.001) in patients with BDD (53%) than in those without this disorder (11%). The prevalence of anxiety was significantly higher (p<0.001) in patients with BDD (67%) than in those without this disorder (23%). With increasing age, the BDD scores decrease slightly, but this difference was not statistically significant (p=0.113).
Conclusion: The prevalence of BDD in the study population was 17.4%. The high prevalence of the disorder in orthognathic surgery patients compared to the general population requires the serious attention of dentists to this disorder.


Main Subjects

  1. Herbst I, Jemec GBE. Body dysmorphic disorder in dermatology: a systematic review. Psychiatr Q. 2020;91(4):1003-10. doi: 10.1007/s11126-020- 09757-y. PMID: 32472234.
  2. Jakubietz M, Jakubietz RJ, Kloss DF, Gruenert JJ. Body dysmorphic disorder: diagnosis and approach. Plast Reconstr Surg. 2007; 119:1924-30. doi: 10.1097/01.prs.0000259205.01300.8b. PMID: 17440376.
  3. Phillips KA, McElroy SL, Hudson JI, Pope HG Jr. Body dysmorphic disorder: an obsessivecompulsive spectrum disorder, a form of affective spectrum disorder, or both? J Clin Psychiatry. 1995;56(4):41-51. PMID: 7713865.
  4. Wilson JB, Arpey CJ. Body dysmorphic disorder: suggestions for detection and treatment in a surgical dermatology practice. Dermatol Surg. 2004;30(11):1391–9. doi: 10.1111/j.1524-4725. 2004.30433. x. PMID: 15522020.
  5. Aouizerate B, Pujol H, Grabot D, Faytout M, Suire K, Braud C, et al. Body dysmorphic disorder in a sample of cosmetic surgery applicants. Eur Psychiatry. 2003;18(7):365–8. doi: 10.1016/j. eurpsy.2003.02.001. PMID: 14643566.
  6. Vindigni V, Pavan C, Semenzin M, Granà S, Gambaro F, Marini M, et al. The importance of recognizing body dysmorphic disorder in cosmetic surgery patients: do our patients need a preoperative psychiatric evaluation? Eur J Plast Surg. 2002;25(6):305–8. doi: 10.1007/s00238- 002-0408-2.
  7. Vulink NC, Rosenberg A, Plooij JM, Koole R, Bergé SJ, Denys D. Body dysmorphic disorder screening in maxillofacial outpatients presenting for orthognathic surgery. Int J Oral Maxillofac Surg. 2008;37(11):985-91. doi: 10.1016/j.ijom.2008.06.005 PMID: 18640822.
  8. Collins B, Gonzalez D, Gaudilliere DK, Shrestha P, Girod S. Body dysmorphic disorder and psychological distress in orthognathic surgery patients. Int J Oral Maxillofac Surg. 2014;72(8):1553-8. doi: 10.1016/j.joms.2014.01.011 PMID: 24582136.
  9. Chee IS, Kim HJ, Lee Y, Kim JW. Body dysmorphic disorder, psychiatric symptoms, and quality of life in female dermatological patients. Neuropsychiatr Dis Treat. 2020:16;2921–8. doi: 10.2147/NDT. S284077. PMID: 33311980.
  10. Buhlmann U, Glaesmer H, Mewes R, Fama JM, Wilhelm S, Brähler E, et al. Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Res. 2010;178(1):171-5. Doi: 10.1016/j.psychres.2009. 05.002. PMID: 20452057.
  11. Phillips KA, Dufresne RG Jr, Wilkel CS, Vittorio CC. Rate of body dysmorphic disorder in dermatology patients. J Am
    Acad Dermatol. 2000;42(3):436-41. Doi: 10.1016/s0190- 9622(00)90215-9. PMID: 10688713.
  12. Rabiee M, Khorramdel K, Kalantari M, Molavi H. Factor structure, validity and reliability of the modified Yale-brown obsessive compulsive scale for body dysmorphic disorder in students. IJPCP. 2010;15(4):343-50.
  13. Hamidi R, Fekrizadeh Z, Azadbakht M, Garmaroudi G, Taheri Tanjani P, Fathizadeh S, et al. Validity and reliability Beck Depression Inventory-II among the Iranian elderly population. JSUMS. 2015;22(1):189-98.
  14. Rafiei M, Seifi A. An investigation into the reliability and validity of beck anxiety inventory among the university students. J Thought Behav Clin. 2013;22(1): 43-50.