Body Dysmorphic Disorder in Japanese Orthodontic Patients

Objectives: Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, is associated with markedly impaired psychosocial functioning, suicidality, and notably poor quality of life. People with BDD seek appearance enhancing medical treatments, such as cosmetic surgery and dermatological treatment (Sarwer DB, Crerand CE, Body image, 208). Although orthodontic treatment and whitening may be the most frequently sought and received dental treatment by patients with BDD, little information about frequency of BDD in orthodontic clinics has been reported. Therefore, the present study was to investigate the frequency of BDD in Japanese orthodontic patients. Methods: The subjects of the present study were 82 patients visiting orthodontic clinics and 78 patients visiting general dental clinics. The subjects were asked their condition upon their first visit to orthodontic and general dental clinics based on the questionnaire assessing Diagnostic and Statistical Manual of mental disorders (DSM-IV-TR criteria) for BDD. Since BDD patients are often accompanied by depression, the degree of depression was estimated by Beck Depression Inventory (BDI). We used the Sheehan Disability Scale to measure the state of everyday life function before the orthodontic treatment. The data was compared between orthodontic and general dental patients using chi-square test for prevalence of BDD, and using student's t test for BDI and Sheehan Disability Scale. Results: Based on DSM-IV-TR criteria, prevalence of BDD in orthodontic patients and in general dental patients were 7.31% (n=6) and 1.28% (n=1), respectively. The prevalence of BDD in orthodontic patients was significantly higher than that in general dental patients (p<0.05). There was no significant difference between orthodontic and general dental patients in BDI and Sheehan Disability Scale. Conclusions: The results indicate that the BDD patients may more frequently visit orthodontic clinics than general dental clinics.