Body Dysmorphic Disorders

身体畸形障碍
  • 文章类型: Journal Article
    背景:本报告评估了人工智能(AI)在心理皮肤病学中的潜力,强调其提高诊断准确性的能力,治疗功效,个性化护理。精神病学,探讨了心理健康和皮肤病之间的联系,将受益于AI先进的数据分析和模式识别功能。
    方法:在PubMed和GoogleScholar上进行了文献检索,从2004年到2024年,遵循PRISMA指南。研究包括证明AI在预测身体畸形障碍治疗结果方面的有效性,识别牛皮癣和焦虑症中的生物标志物,完善治疗策略。
    结果:该综述确定了几项研究强调AI在改善心理皮肤病学治疗结果和诊断准确性方面的作用。AI在预测身体畸形障碍的结果以及识别与牛皮癣和焦虑症相关的生物标志物方面是有效的。然而,挑战,如皮肤科医生知识有限,整合困难,并注意到有关患者隐私的伦理问题。
    结论:人工智能通过提高诊断精度,在推进皮肤病学方面具有重要的前景。治疗效果,个性化护理。尽管如此,实现这一潜力需要大规模的临床验证,增强了数据集的多样性,和强大的道德框架。未来的研究应该集中在这些领域,与跨学科合作对于克服当前挑战和优化心理皮肤病学患者护理至关重要。
    BACKGROUND: This report evaluates the potential of artificial intelligence (AI) in psychodermatology, emphasizing its ability to enhance diagnostic accuracy, treatment efficacy, and personalized care. Psychodermatology, which explores the connection between mental health and skin disorders, stands to benefit from AI\'s advanced data analysis and pattern recognition capabilities.
    METHODS: A literature search was conducted on PubMed and Google Scholar, spanning from 2004 to 2024, following PRISMA guidelines. Studies included demonstrated AI\'s effectiveness in predicting treatment outcomes for body dysmorphic disorder, identifying biomarkers in psoriasis and anxiety disorders, and refining therapeutic strategies.
    RESULTS: The review identified several studies highlighting AI\'s role in improving treatment outcomes and diagnostic accuracy in psychodermatology. AI was effective in predicting outcomes for body dysmorphic disorder and identifying biomarkers related to psoriasis and anxiety disorders. However, challenges such as limited dermatologist knowledge, integration difficulties, and ethical concerns regarding patient privacy were noted.
    CONCLUSIONS: AI holds significant promise for advancing psychodermatology by improving diagnostic precision, treatment effectiveness, and personalized care. Nonetheless, realizing this potential requires large-scale clinical validation, enhanced dataset diversity, and robust ethical frameworks. Future research should focus on these areas, with interdisciplinary collaboration essential for overcoming current challenges and optimizing patient care in psychodermatology.
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  • 文章类型: Journal Article
    在痛苦不耐受(DI)中升高的个体可能会采取功能失调的行为策略来应对他们的痛苦。一种可能与DI相关的行为策略是与外观相关的安全行为(ARSB;即适应不良的行为,旨在减轻对外观的负面评价的可怕后果)。我们在两个独立的女性样本中检查了DI和ARSB之间的关系。在研究1中(N=91),我们在一个未经筛选的样本中发现,ARSB在横截面上与DI密切相关,同时考虑了抑郁症和身体畸形的症状.Further,较大的ARSB预测DI纵向增加。在研究2中,在一个临床样本中,有升高的外观问题的女性(N=94),与自我监测对照相比,我们检查了降低ARSB的实验效果。相对于控制,降低ARSB的指令导致降低DI,但这种影响仅在基线DI低的个体中发现。总的来说,我们发现初步证据表明,ARSB可能是促成和维持DI的显著因素;而SB衰落可能是降低DI的有用策略.我们在现有文献的背景下讨论这些发现,并为未来的研究提供方向。
    Individuals elevated in distress intolerance (DI) may engage in dysfunctional behavioral strategies to cope with their distress. One behavioral strategy that may be related to DI is appearance related safety behavior (ARSB; i.e., maladaptive behavior that seeks to mitigate the feared consequences of the negative evaluation of appearance). We examined the relationship between DI and ARSBs in two separate samples of women. In Study 1 (N = 91), we found in an unselected sample that ARSBs were robustly associated with DI cross-sectionally while accounting for symptoms of depression and body dysmorphia. Further, greater ARSBs predicted increases in DI longitudinally. In Study 2, among a clinical sample of women with elevated appearance concerns (N = 94), we examined the experimental effect of reducing ARSBs compared to a self-monitoring control. Relative to control, instructions to reduce ARSBs led to lower DI, but this effect was only found for individuals low in baseline DI. Overall, we found preliminary evidence that ARSBs may be a salient factor in contributing to and maintaining DI; and SB fading may be a helpful strategy for reducing DI. We discuss these findings in the context of existing literature and provide directions for future research.
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  • 文章类型: Journal Article
    这项研究旨在确定加拿大青少年和年轻人使用肌酸一水合物与肌肉畸形症状之间的前瞻性关联。分析了来自加拿大青少年健康行为研究的912名青少年和年轻人的数据。在第1波中评估了过去12个月中肌酸一水合物的使用,并在第1波和第2波中使用肌肉畸形症量表(MDDI)测量了肌肉畸形症状。使用线性回归分析确定了一水肌酸使用与MDDI总分和子量表得分之间的前瞻性关联。控制相关人口统计学识别符的回归分析,先前的物质使用,和相应的Wave1MDDI变量。在第1波中使用肌酸一水合物与总肌肉变形症状学(B1.34,95%CI0.27,2.42)和在第2波中更大的外观不耐受(B0.52,95%CI0.02,1.03)具有前瞻性。重要的是,这些发现与先前的肌肉变形症状无关,终生使用合成代谢-雄激素类固醇,终身使用香烟,和饮酒频率。一水合肌酸常用于青少年和年轻人。这项研究的发现是最早证明肌酸一水合物的使用可能是青少年和年轻人中肌肉畸形症状发展的危险因素之一。健康和精神卫生保健专业人员可能会考虑评估青少年和年轻人的肌酸一水合物使用和肌肉畸形症状。
    This study aimed to determine the prospective association between creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults in Canada. Data from 912 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Creatine monohydrate use in the past 12 months was assessed at Wave 1, and muscle dysmorphia symptomatology was measured using the Muscle Dysmorphic Disorder Inventory (MDDI) at Wave 1 and Wave 2. The prospective associations between creatine monohydrate use and the MDDI total score and subscale scores were determined using linear regression analyses. Regression analyses controlled for relevant demographic identifiers, prior substance use, and the corresponding Wave 1 MDDI variable. Creatine monohydrate use at Wave 1 was prospectively associated with both total muscle dysmorphia symptomatology (B 1.34, 95 % CI 0.27, 2.42) and greater Appearance Intolerance (B 0.52, 95 % CI 0.02, 1.03) at Wave 2. Importantly, these findings were independent of prior muscle dysmorphia symptomatology, lifetime anabolic-androgenic steroid use, lifetime cigarette use, and frequency of alcohol use. Creatine monohydrate is commonly used among adolescents and young adults. Findings from this study are among the first to document that creatine monohydrate use may be a risk factor for the development of muscle dysmorphia symptomatology among adolescents and young adults. Health and mental health care professionals may consider assessing for both creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults.
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  • 文章类型: Journal Article
    为了评估有效性,基于互联网的认知行为疗法(CBT)治疗身体畸形障碍的成本效益和可行性。
    方法:系统综述于2023年8月19日至9月22日进行,并在Cochrane图书馆进行了搜索,Embase,谷歌学者,PubMed,从2010年起,PsycINFO和WebofScience数据库使用特定的关键词进行英语研究。还搜索了灰色文献和相关的会议记录,以包括尽可能多的研究,这些研究研究了基于互联网的认知行为疗法在治疗身体畸形障碍中的作用。完成了数据提取,选定的研究进行了质量评估,然后是对研究结果的叙述性综合。
    结果:在最初确定的6837项研究中,8(0.11%)进行了详细分析。在这8项研究中,4(50%)为RCT,而在瑞典进行了5次(62.5%)。治疗师指导的基于互联网的认知行为治疗干预措施一致证明了在减少身体畸形障碍症状严重程度方面的功效。提高洞察力,提高生活质量。成本效益分析强调了基于互联网的认知行为疗法的有利经济方面。高参与者参与度和满意度证明了可行性和可接受性。
    基于互联网的认知行为疗法在解决身体畸形障碍治疗中的治疗差距方面显示出希望,提供无障碍,具有成本效益和可行性的干预措施。
    UNASSIGNED: To evaluate the effectiveness, cost-effectiveness and feasibility of internet-based Cognitive Behavioural Therapy (CBT) in the treatment of body dysmorphic disorder.
    METHODS: The systematic review was conducted from August 19 to September 22, 2023, and comprised search on Cochrane Library, Embase, Google Scholar, PubMed, PsycINFO and Web of Science databases using specific key words for studies published in the English language from 2010 onwards. Grey literature and pertinent conference proceedings were also searched to include as many studies as possible that investigated internet-based cognitive behavioural therapy in the treatment of body dysmorphic disorder. Data extraction was done, and the selected studies were subjected to quality assessment, followed by a narrative synthesis of the findings.
    RESULTS: Out of the 6,837 studies initially identified, 8(0.11%) were analysed in detail. Of the 8 studies, 4(50%) were RCTs, while 5(62.5%) had been conducted in Sweden. Therapist-guided internet-based cognitive behavioural therapy interventions consistently demonstrated efficacy with respect to reducing body dysmorphic disorder symptom severity, improving insight, and enhancing quality of life. Cost-effectiveness analyses highlighted the favourable economic aspect of internet-based cognitive behavioural therapy. Feasibility and acceptability were demonstrated by high participant engagement and satisfaction.
    UNASSIGNED: Internet-based cognitive behavioural therapy showed promise in addressing the treatment gap in body dysmorphic disorder care, offering accessible, cost-effective and feasible interventions.
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  • 文章类型: Journal Article
    越来越多的经验关注不良儿童经历(ACE)在身体畸形障碍(BDD)的发展和维持中的作用。然而,目前的研究主要集中在成人和非临床BDD样本上,关于ACEs在青少年BDD中的相关性知之甚少。本研究检查了(a)主要诊断为BDD(n=50)和强迫症(OCD)(n=50)的青少年ACE的频率,以及(b)暴露于ACE的青少年BDD的临床特征。通过系统搜索电子病历来确定ACE,以及通过父母和自我报告筛查项目暴露于创伤事件。结果显示,同伴受害率较高(74%vs.38%)和儿童虐待(44%vs.24%)在BDD与OCD青年中;根据患者记录,性虐待是BDD组中记录的最常见的儿童虐待类型(28%)。父母报告的创伤事件暴露在BDD中也显着高于强迫症组(40%vs.18%,分别)。有和没有ACE病史的患者的临床表现和治疗结果没有差异。目前的研究是第一个证明一系列ACE在青少年BDD中很常见的研究。我们的发现强调了筛查这些经历的重要性。虽然还需要进一步的研究,我们的发现还表明,有ACE病史的BDD青少年在临床表现上与无ACE的青少年大致相似,并受益于以BDD为重点的治疗。
    Increasing empirical attention has been given to the role of adverse childhood experiences (ACEs) in the development and maintenance of body dysmorphic disorder (BDD). Yet, current research has predominantly focused on adult and nonclinical BDD samples, and little is known about relevance of ACEs in adolescent BDD. The present study examined (a) the frequency of ACEs in adolescents with a primary diagnosis of BDD (n = 50) versus obsessive compulsive disorder (OCD) (n = 50) and (b) the clinical profile of ACE-exposed youth with BDD. ACEs were ascertained through a systematic search of electronic patient records, as well as through a parent- and self-report screening item for exposure to traumatic events. Results showed higher rate of peer victimisation (74% vs. 38%) and child maltreatment (44% vs. 24%) among BDD versus OCD youths; sexual abuse was the most common type of child maltreatment documented in the BDD group (28%) according to patient records. Parent-reported exposure to traumatic events was also significantly higher in the BDD than the OCD group (40% vs. 18%, respectively). Clinical presentation and treatment outcomes did not differ between those with versus without a history of ACEs. The current study is the first to demonstrate that a range of ACEs are common in adolescent BDD. Our findings highlight the importance of screening for these experiences. Although further research is needed, our findings also indicate that adolescents with BDD who have a history of ACEs are broadly similar in their clinical presentation to those without, and benefit from BDD-focused treatment.
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  • 文章类型: Journal Article
    本研究旨在确定身体畸形障碍(BDD)的患病率,其临床特征,以及申请整形和重建手术的患者的合并症。
    向整形和重建手术门诊申请的五百七十九名参与者填写了一份社会人口统计学数据表格,并接受了身体感知量表(70-nineBPS),社会表象焦虑量表(SAAS),TEMPS-A气质量表,和贝克抑郁量表(BDI)。在BPS上得分超过135的参与者被纳入精神病学访谈。接下来,将被诊断为BDD的参与者与具有高BPS评分但没有BDD诊断的参与者进行比较,还有一个对照组。
    在整形外科门诊就诊的所有患者中,BDD的患病率为4.7%,而在专门寻求整容手术的人群中,患病率为8.6%。平均SAAS,BDI,TEMPS-A抑郁,与对照组相比,BDD组的焦虑评分更高(p<0.001)。平均SAAS的差异,BDI,TEMPS-A抑郁,BPS评分高的患者和对照组的焦虑评分与BDD组和对照组之间观察到的差异相当。回归分析显示,SAAS和抑郁气质评分对BPS评分有影响。
    在寻求整形和重建手术的患者中,BDD的合并症非常高,这突显了识别这些患者以防止不必要的外科手术的重要性。
    UNASSIGNED: The present study aimed to determine the prevalence of body dysmorphic disorder (BDD), its clinical features, and comorbidities in patients applying for plastic and reconstructive surgery.
    UNASSIGNED: Five-hundred and seventy nine participants who applied to the plastic and reconstructive surgery outpatient clinic completed a sociodemographic data form, and were subjected to the Body Perception Scale (seventy-nineBPS), Social Appearance Anxiety Scale (SAAS), TEMPS-A Temperament Scale, and Beck Depression Inventory (BDI). Participants who scored 135 or more on the BPS were included in a psychiatric interview. Next, the participants diagnosed with BDD were compared with participants with a high BPS scores but without a BDD diagnosis, along with a control group.
    UNASSIGNED: The prevalence of BDD among all patients attending the plastic surgery outpatient clinic was found to be 4.7%, whereas the prevalence was 8.6% among those specifically seeking cosmetic procedures. The mean SAAS, BDI, TEMPS-A depressive, and anxious scores were higher in the BDD group compared to the controls (p < 0.001). The difference in the mean SAAS, BDI, TEMPS-A depressive, and anxious scores of the patients with a high BPS scores and the control group was comparable to the difference observed between the BDD and control groups. A regression analysis revealed that the SAAS and depressive temperament scores have an effect on the BPS score.
    UNASSIGNED: The significantly high comorbidity of BDD in patients seeking plastic and reconstructive surgery underscores the importance of identifying these patients to prevent unnecessary surgical procedures.
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  • 文章类型: Journal Article
    皮肤科医生通常会看到患有炎症性皮肤病和美学问题的患者,这些患者涉及严重的心理合并症。然而,大多数皮肤科医生没有接受这方面的正式培训,许多人不确定如何从整体上最好地帮助某些患者。身体畸形障碍(BDD)是一种常见且令人痛苦的精神疾病,对皮肤病患者产生不成比例的影响,包括患有慢性炎症性皮肤病如痤疮和特应性皮炎的患者。BDD的特征是专注于物理外观上不存在或最少明显的缺陷,这些缺陷会导致临床上明显的困扰或功能受损。青少年人群可能特别容易受到临床上显著的身体形象不满,包括BDD,由于痤疮的高患病率和社交媒体平台的普遍作用。社交媒体的兴起可能会通过反复接触理想化且通常不切实际的美容标准而加剧身体形象问题。虽然筛查问卷可以帮助皮肤科医生识别BDD,皮肤科医生必须与心理健康提供者合作,为弱势患者提供全面护理,包括青少年。J药物Dermatol.2024;23(7):545-550。doi:10.36849/JDD.8156。
    Dermatologists routinely see patients with inflammatory skin conditions and aesthetic concerns that involve substantial psychological comorbidity. However, most dermatologists do not receive formal training in this area, and many are unsure how to best help treat certain patients holistically. Body dysmorphic disorder (BDD) is a common and distressing psychiatric condition that disproportionately impacts dermatology patients, including patients living with chronic inflammatory skin conditions such as acne and atopic dermatitis. BDD is characterized by preoccupation with nonexistent or minimally noticeable flaws in physical appearance that cause clinically significant distress or impairment in functioning. Adolescent populations may be particularly vulnerable to clinically significant body image dissatisfaction, including BDD, due to the high prevalence of acne and the pervasive role of social media platforms. The rise of social media may exacerbate body image issues through repetitive exposure to idealized and often unrealistic beauty standards. Though screening questionnaires can assist dermatologists in recognizing BDD, dermatologists must collaborate with mental health providers to provide comprehensive care to vulnerable patients, including adolescents.J Drugs Dermatol. 2024;23(7):545-550.  doi:10.36849/JDD.8156.
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  • 文章类型: Journal Article
    总的来说,男性患者寻求隆鼻手术的人数少于女性。两种人群的手术原理相似,需要注意一些特殊的解剖学考虑。男性隆鼻患者的身体畸形综合征发生率较高,患者满意度也有较大的挑战。在该人群中进行美容手术时,咨询过程需要彻底和深思熟虑,以最大程度地获得积极成果。
    In general, fewer male patients seek rhinoplasty surgery than females. The surgical principles are similar in both populations with some special anatomic considerations that will need attention. There is a higher rate of body dysmorphic syndrome in males seeking rhinoplasty as well as greater challenges with patient satisfaction, and the consultation process needs to be thorough and deliberate when undertaking aesthetic surgery in this population to maximize positive outcomes.
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  • 文章类型: Systematic Review
    为了了解身体畸形障碍(BDD)的外观缺陷的视觉优势,视觉处理的研究越来越多。研究集中在面部和其他基本视觉刺激上。目前的文献没有提供一致的行为模式的证据,缺乏描述BDD中视觉处理的总体工作。本系统评价旨在描述BDD中视觉处理异常和/或缺陷的行为结果。文章通过在线数据库MEDLINE和PubMed收集,如果他们包括临床BDD组,1990年后出版。结果表明,患有BDD的个体在情绪面部处理方面表现出缺陷,可能过度依赖细节处理,异常的眼睛扫描行为,以及高估吸引力的倾向。虽然研究结果一致表明BDD的视觉缺陷,缺乏明确的类型。这种不一致性可能归因于BDD样本内的异质性和实验设计的差异(即,刺激,任务,条件)。很难区分与BDD相关的缺陷和与OCD或饮食失调相关的缺陷。一个连贯的框架,包括样本表征和任务设计将寻求产生清晰和一致的行为模式,以指导未来的治疗。
    To understand the visual preponderance of perceived flaws in appearance in body dysmorphic disorder (BDD), the study of visual processing has been growing. Studies have focused on facial and other basic visual stimuli. The current literature does not provide evidence of consistent behavioural patterns, lacking an overarching body of work describing visual processing in BDD. This systematic review aims to characterise behavioural outcomes of visual processing anomalies and/or deficits in BDD. Articles were collected through online databases MEDLINE and PubMed, and were included if they comprised a clinical BDD group, and were published after 1990. Results indicate that individuals with BDD demonstrate deficits in emotional face processing, a possible overreliance on detail processing, aberrant eye-scanning behaviours, and a tendency to overvalue attractiveness. While findings consistently signal towards visual deficits in BDD, there is lack of clarity as to the type. This inconsistency may be attributed to heterogeneity within BDD samples and differences in experimental design (i.e., stimuli, tasks, conditions). There are difficulties distinguishing between BDD-associated deficits and those associated with OCD or eating disorders. A coherent framework, including sample characterisation and task design will seek to generate clear and consistent behavioural patterns to guide future treatments.
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  • 文章类型: Journal Article
    在男性气质和男性精神病理学的动态模型的指导下,当前的研究旨在探索男性差异压力和每个肌肉畸形维度(驱动大小,外观不容忍,和功能障碍)在男性性别角色差异与男性抑郁之间的关联中。对于目前的研究,936名以色列男子完成了一份结构化的自我报告问卷。发现男性差异压力和某些肌肉畸形维度部分介导了男性性别角色差异与男性抑郁之间的关联。研究结果表明,社会性别期望和男性性别角色差异的内在化如何反映在自我意识与典型男性之间的差距上,这最终与心理健康结果有关。反过来,男人试图通过他们认为的男性来减轻压力,反映肌肉畸形:驱动尺寸,外观不容忍,和功能障碍,反过来预测男性抑郁症。因此,建议精神和身体健康专业人员意识到这些机制,为了认识到传统社会性别角色期望产生的负面心理健康结果,并为他们提供具体的解决方案。
    Guided by the dynamic model of masculinity and men\'s psychopathology, the current study aimed to explore the mediating role of masculine discrepancy stress and each of the muscle dysmorphia dimensions (drive for size, appearance intolerance, and functional impairments) in the association between masculine gender role discrepancy and masculine depression. For the present study, 936 Israeli men completed a structured self-report questionnaire. Masculine discrepancy stress and some of the muscle dysmorphia dimensions were found to partially mediate the association between masculine gender role discrepancy and masculine depression. The findings demonstrate how the internalization of social gender expectations and men\'s gender role discrepancy is reflected in the gap between perception of self and the typical man, which is eventually related to mental health outcomes. In turn, men attempt to mitigate the stress through what they perceive as masculine, reflecting muscle dysmorphia: drive for size, appearance intolerance, and functional impairments, which in turn predict masculine depression. Therefore, mental and physical health professionals are advised to be aware of these mechanisms, in order to recognize the negative mental health outcomes arising from traditional societal gender role expectations and provide specific solutions for them.
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