Body dysmorphic disorder: case report

The desire for self-mutilation in the absence of any discernible psychopathology is relatively rare. Self-mutilation is most commonly a manifestation of an underlying psychopathology such as depression, schizophrenia, personality disorder, transexuality, body dysmorphic disorder and factitious disorder. In this article, a case in which a 29-year-old single Kenyan lady of African origin demanded a surgical operation to modify and reduce the size of her external genitalia is presented. Although female genital mutilation is still widespread in the country, this case is of interest in that the woman did not seek the usual circumcision but sought to specifically reduce the size of her labia minora so that she could feel like a normal woman. The unique challenges in her management are discussed. Possible aetiological factors in patients who demand surgical removal or modification of parts of their bodies without an obvious cause is discussed.     

躯体变形障碍问卷的修订考评

Objective To evaluate the reliability and validity of body dysmorphic disorder questionnaire (BDDQ) Chinese version. Methods A total of 222 participants from a plastic surgery department were enrolled in the study by systematic sampling. They were measured with BDDQ Chinese version and interviewed with Structured Clinical Interview for DSM-]V-TR-Patients( SCID/P) to evaluate the validity. Fifty participants were assessed again after two weeks to evaluate the test-retest reliability. Results The sensitivity of BDDQ Chinese version was 100% and the specificity was 93%. The correlation coefficient of each item was between 0. 808 and 1.000(P＜ 0.001). Conclusion BDDQ Chinese version has fairly high reliability and validity. Thus, it can be used as a screening diagnosis tool for BDD.     

躯体变形障碍问卷的修订考评

目的 修订躯体变形障碍问卷(Body Dysmorphic Disorder Questionnaire,BDDQ)并检验其信度与效度.方法 系统抽样222名美容整形科求术者进行BDDQ中文版的施测及临床访谈,以DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查病人版(SCID/P)的BDD诊断作为"金标准"检验BDDQ的效度,对其中50名被调查者于第1次访谈结束两周后再次进行施测以检验BDDQ的重测信度.结果 BDDQ中文版诊断BDD的灵敏度为100%,特异度93%,问卷各条目两次测量结果之间的相关系数在0.808～1.000之间(P＜0.001).结论 BDDQ中文版对诊断BDD有较好的信效度,适合作为BDD的筛查诊断工具.

Abstract：

Objective To evaluate the reliability and validity of body dysmorphic disorder questionnaire (BDDQ) Chinese version. Methods A total of 222 participants from a plastic surgery department were enrolled in the study by systematic sampling. They were measured with BDDQ Chinese version and interviewed with Structured Clinical Interview for DSM-]V-TR-Patients( SCID/P) to evaluate the validity. Fifty participants were assessed again after two weeks to evaluate the test-retest reliability. Results The sensitivity of BDDQ Chinese version was 100% and the specificity was 93%. The correlation coefficient of each item was between 0. 808 and 1.000(P＜ 0.001). Conclusion BDDQ Chinese version has fairly high reliability and validity. Thus, it can be used as a screening diagnosis tool for BDD.     

Brazilian version of the body dysmorphic disorder examination.

CONTEXT AND OBJECTIVE: Body image improvement is considered to be the main reason for undergoing plastic surgery. The objective was to translate the Body Dysmorphic Disorder Examination (BDDE) into Brazilian Portuguese and to adapt and validate this questionnaire for use in Brazil. DESIGN AND SETTING: Cross-sectional survey, at the Department of Plastic Surgery of Universidade Federal de S?o Paulo. METHODS: The BDDE was first translated into Portuguese and then back-translated into English. These translations were then discussed by healthcare professionals in order to establish the final Brazilian version. In a second stage, the validity and reliability of the BDDE were assessed. For this, patients were initially interviewed by two interviewers and subsequently, by only one of these interviewers. On the first occasion, in addition to the BDDE, the body shape questionnaire (BSQ) and the Rosenberg self-esteem scale were also applied. These questionnaires were applied to 90 patients. RESULTS: Six questions were modified during the assessment of cultural equivalence. Cronbach's alpha was 0.89 and the intraclass correlation coefficients for interobserver and test-retest reliability were 0.91 and 0.87, respectively. Pearson's coefficient showed no correlation between the BDDE and the Rosenberg self-esteem scale (0.22), whereas there was a moderate correlation between the BDDE and the BSQ (0.64). CONCLUSIONS: The BDDE was successfully translated and adapted, with good internal consistency, reliability and construct validity.     

海南大学生躯体变形障碍患病率调查分析

目的:了解海南大学生躯体变形障碍的患病率其及影响因素。方法:应用自编调查问卷、体象障碍自评量表等对海南五所高校一年级至四年级的大学生2 463人进行分层整群随机抽样调查和分析。结果:海南大学生中检出躯体变形障碍患病率为4.95%,不同性别、年级、民族、年龄的海南大学生躯体变形障碍患病率差异无统计学意义(P>0.05)。结论:海南大学生躯体变形障碍的患病率为4.95%,与性别、民族、年级、年龄无关。     

Screening for body dysmorphic disorder among patients pursuing cosmetic surgeries in Saudi Arabia

Objectives:To determine the prevalence of positive screening of body dysmorphic disorder (BDD) among patients seeking cosmetic surgeries in plastic surgery and oculoplastic surgery clinics.Methods:The survey of this cross-sectional study was self-administrated and distributed among adults pursuing cosmetic surgeries in plastic surgery and oculoplastic surgery clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between March 2019 and March 2020. The BDD questionnaire was validated, and a highly sensitive and specific tool was used to identify patients with BDD. Ethical approval was granted by the Research Ethics Committee. All analytic studies were performed using IBM SPSS, version 24.Results:A total of 344 patients participated in this study with a mean age of 39.66 ± 13.76 years. Of these, 296 (86%) were women and 298 (86.6%) were Saudi. The prevalence of positive screening for BDD was 19.2%. The most commonly requested procedures were abdominoplasty (21.2%) and skin lesion removal (21.2%). Smoking was found to be significantly associated with BDD with 21.2% of smokers having it (p<0.010).Conclusion:Body dysmorphic disorder was unrecognized among patients pursuing cosmetic surgeries. One-fifth of patients requesting cosmetic procedures are potential cases of BDD requiring psychiatric evaluation and treatment. We recommend implementing screening protocols to identify cases before surgical plans.     

帕罗西汀联合MECT治疗体像障碍对照研究

目的:探讨帕罗西汀联合MECT治疗体像障碍的临床疗效.方法:将26例体像障碍患者随机分为研究组、对照组各13例,两组均用帕罗西汀治疗,研究组联合MECT治疗.疗程8周.于治疗前及治疗第2,4,8周末采用鲁龙光体像障碍(BDD)量表、汉密顿焦虑量表(HAMA)评定临床疗效;TESS评定副反应.结果:两组均自治疗第2周末BDD量表及HAMA分值均开始下降,研究组低于对照组(P＜0.05),第8周末两组间差异有统计学意义(P＜0.01).结论:帕罗西汀合并MECT治疗与单一帕罗西汀治疗BDD均有显著疗效,前者治疗效果更好,起效更快.     

Rickets and dysmorphic findings in a child with abetalipoproteinemia

Abetalipoproteinemia (ABL) is characterized by acanthocytosis, hypocholesterolemia, and steatorrhea. Here, we describe a case of ABL associated with rickets and dysmorphic findings and the subsequent therapeutic course in an 18-month-old male referred for evaluation for failure to thrive and chronic fatty diarrhea. Examination revealed a pale child, dysmorphic face, and signs of rickets. Laboratory examination revealed low hemoglobin (3.7 gm/dl), low albumin (28 gm/L), low cholesterol and triglyceride levels. The blood smear showed acanthocytes while the small bowel histology showed the enterocytes were distended with lipid droplets. He was diagnosed with ABL and treated with fat-soluble vitamins (ADEK), and hydrolyzed protein formula containing medium chain triglycerides. Three months later, his fatty diarrhea becomes normal stool, his serum fat-soluble vitamins normalized, and his weight increased from 4.1 kg to 5.9 kg.     

Familial complex chromosomal rearrangement in a dysmorphic child with global developmental delay

We report the unusual case of a dysmorphic child with global developmental delay secondary to a familial complex chromosomal rearrangement (CCR). His chromosomal analysis using G-banding and dual colour fluorescence in situ hybridisation with whole chromosome paint revealed a supernumerary marker chromosome as a result of malsegregation of a familial CCR involving chromosomes 7, 12 and 14. The balanced form of this familial CCR was also carried by the patient's mother and maternal grandmother, both of whom had a history of recurrent spontaneous abortions, as well as his maternal uncle, who was infertile. To the best of our knowledge, this is the first reported case of familial CCR involving chromosomes 7, 12 and 14. This case also highlights the importance of chromosomal analysis in children with dysmorphism and developmental delay as well as in adults who suffer from recurrent spontaneous abortions or infertility.     

Body Firming

年纪越长．肌肤便愈见松弛，橙皮脂肪亦会随之而来，爱美的女士们，不得不加以防范。除了加强运动和调节饮食外，还可以求助于一些有紧肤功效的美容品。[编者按]     

Body notebook

保暖轻便要兼顾 穿羽绒服运动总觉得很臃肿,为此阿迪达斯推出户外梭织超轻羽绒茄克和户外梭织羽绒连帽茄克。这两款服装均采用内充蓬松度650的鹅绒,轻盈却不失保暖功效。而且该系列还拥有多种绚丽色彩,不失为户外运动的好选择。     

Medical genetics: 2. The diagnostic approach to the child with dysmorphic signs

DYSMORPHOLOGY IS THE BRANCH OF CLINICAL GENETICS in which clinicians and researchers study and attempt to interpret the patterns of human growth and structural defects. Reaching an accurate diagnosis for children with dysmorphic signs is important to their families, because it makes available all the accumulated knowledge about the relevant condition and may provide the family with the opportunity for interaction with patient or parent support groups. I show in this review that reaching a diagnosis in dysmorphology involves an approach that is not fundamentally different from that of other medical disciplines. Cytogenetic and molecular techniques continue to improve our ability to make precise syndrome diagnoses; however, these tests are expensive and should be used selectively.     

Body Composition and Body Weight: Criteria of Overnutrition

The terms “body weight” and “body composition” are by no means synonymous, and attention is increasingly being focused on body composition. A measurement of relative fatness is a better criterion of caloric overnutrition than is body weight.

The simple technique of skinfold measurement using established standard methods is the most practical for use in the field to obtain an estimate of fatness or caloric overnutrition. The current need is for the establishment of “norms” for skinfolds for population groups of all ages and both sexes. When these are established, excellent simple criteria for overnutrition will be available.

Prior to the establishment of norms, more work is needed to indicate which skinfolds for each age group and for each sex best reflect total body fatness. Body fatness may then be studied in relation to body weight and both may be related to morbidity, mortality and longevity. Finally, the answer may be obtained to the question whether it is overweight per se or overfatness that is related to excess morbidity and mortality.

     

Cerebrovascular disorder

<正>210216 Survival and differentiation of transplanted human embryonic stem cells 48 h following cerebral infarction in rats/Chen Ling(陈凌,Dept Cytotherapy,Xuanwu Hosp,Cap Med Univ,Beijing 100053)….-2010,27(4).-487～489