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
    背景:基于互联网的认知行为疗法(CBT)和独立的正念冥想干预措施正在为各种心理健康状况提供经验支持。在这项研究中,我们测试了基于网络的治疗师指导的基于正念的认知行为疗法(CBT-M)对身体畸形障碍(BDD)的疗效,一种精神病,其特征是关注外观上的缺陷。
    目的:本研究旨在确定网络上提供的BDD的CBT-M是否可行和可接受,以及正念冥想是否会增加BDD的CBT治疗效果。
    方法:在这8周,双臂,平行先导随机对照试验,n=28名成年人(年龄在18至55岁之间)被随机分配到实验组(基于网络的治疗师指导的CBT-M)或对照组(基于网络的治疗师指导的CBT)。研究保留,应计,并评估干预依从性,以及BDD的自我报告措施,抑郁症,焦虑,以及基线和干预后的疼痛强度。
    结果:这项研究是可行的,并且被参与者认为是可以接受的。8周后,两个治疗组的所有结局指标均有显着改善,发现BDD症状严重程度有利于CBT-M的大组间效应大小(d=-0.96),抑郁症(d=-1.06),疼痛严重程度(d=-1.12),和疼痛干扰(d=-1.28)。然而,线性混合模型在8周内显示两组间无显著差异.
    结论:结果表明,正念冥想可能会增加BDD基于网络的CBT治疗效果。基于网络的CBT-M的充分授权的随机对照试验是必要的。
    背景:ClinicalTrials.govNCT05402475,http://clinicaltrials.gov/ct2/show/NCT05402475。
    BACKGROUND: Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a psychiatric disorder characterized by preoccupations with perceived defects in appearance.
    OBJECTIVE: This study aims to determine whether CBT-M for BDD delivered on the web is feasible and acceptable and whether mindfulness meditation adds to CBT treatment effects for BDD.
    METHODS: In this 8-week, 2-arm, parallel pilot randomized controlled trial, n=28 adults (aged between 18 and 55 years) were randomly allocated to an experimental group (web-based therapist-guided CBT-M) or a control group (web-based therapist-guided CBT). Study retention, accrual, and intervention adherence were assessed, along with self-report measures for BDD, depression, anxiety, and pain intensity taken at baseline and postintervention.
    RESULTS: This study was feasible to implement and deemed acceptable by participants. After 8 weeks, significant improvements were found on all outcome measures for both treatment groups, and large between-group effect sizes favoring CBT-M were found for BDD symptom severity (d=-0.96), depression (d=-1.06), pain severity (d=-1.12), and pain interference (d=-1.28). However, linear mixed models demonstrated no significant differences between the groups over 8 weeks.
    CONCLUSIONS: The results suggest that mindfulness meditation may add to beneficial web-based CBT treatment effects for BDD. An adequately powered randomized control trial of web-based CBT-M is warranted.
    BACKGROUND: ClinicalTrials.gov NCT05402475, http://clinicaltrials.gov/ct2/show/NCT05402475.
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  • 文章类型: Journal Article
    尚不清楚患有涉及视觉处理改变的精神疾病的个体在视觉任务的感知学习过程中是否采用类似的神经元机制。我们通过训练身体畸形患者来研究这个问题,一种精神病,其特征是令人痛苦或损害专注于一个人的外表不存在或轻微的缺陷,和健康控制对具有低空间频率分量的人脸的视觉检测任务。在行为训练开始之前和结束之后,通过功能磁共振成像测量任务执行过程中的大脑激活。两组参与者都以相似的程度提高了经过训练的任务的绩效。然而,梭形面部区域的神经元变化在组间有很大差异,因此在身体畸形障碍患者的训练后,右梭形面部区域低空间频率面部的激活增加,但在对照组中减少。此外,左右梭形面部区域之间的功能连接在患者训练后下降,但在对照组中增加。我们的结果表明,在身体畸形障碍患者和对照组之间,参与面部检测任务的感知学习的神经元机制根本不同。身体畸形障碍患者中这种不同的神经元机制可能反映了大脑对精神疾病所施加的功能改变的适应。
    It has remained unclear whether individuals with psychiatric disorders involving altered visual processing employ similar neuronal mechanisms during perceptual learning of a visual task. We investigated this question by training patients with body dysmorphic disorder, a psychiatric disorder characterized by distressing or impairing preoccupation with nonexistent or slight defects in one\'s physical appearance, and healthy controls on a visual detection task for human faces with low spatial frequency components. Brain activation during task performance was measured with functional magnetic resonance imaging before the beginning and after the end of behavioral training. Both groups of participants improved performance on the trained task to a similar extent. However, neuronal changes in the fusiform face area were substantially different between groups such that activation for low spatial frequency faces in the right fusiform face area increased after training in body dysmorphic disorder patients but decreased in controls. Moreover, functional connectivity between left and right fusiform face area decreased after training in patients but increased in controls. Our results indicate that neuronal mechanisms involved in perceptual learning of a face detection task differ fundamentally between body dysmorphic disorder patients and controls. Such different neuronal mechanisms in body dysmorphic disorder patients might reflect the brain\'s adaptations to altered functions imposed by the psychiatric disorder.
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  • 文章类型: Systematic Review
    现有证据表明,患有身体形象障碍(BID)的个体容易患抑郁症。这个系统的审查提供了,根据我们的知识,BID与抑郁症之间关联的心理机制的第一个综合。我们对在线数据库进行了彻底的搜索,包括PubMed,WebofScience,和PsycINFO,直到2024年2月发表的文章。最终分析共包括23项研究,重点是心理因素在抑郁和BID之间的中介或调节作用。这篇评论将自尊和社会支持确定为BID与抑郁之间关系的中介和调节者。而感知到的压力只是作为中介。高自尊和强大的社会支持以及低水平的感知压力可能有助于个人经历较低水平的BID,从而降低抑郁症的可能性。旨在提高自尊的干预措施,发展强有力的支持,减少感知压力可能有希望降低BID患者的抑郁风险。
    Available evidence demonstrates that individuals with body-image disturbance (BID) are prone to suffer from depression. This systematic review provides, to our knowledge, the first synthesis of the psychological mechanism of the association between BID and depression. We conducted a thorough search of online databases, including PubMed, Web of Science, and PsycINFO, for articles published up until February 2024. The final analysis comprised a total of 23 studies that focused on the mediating or moderating effects of psychological factors between depression and BID. This review identifies self-esteem and social support as both mediators and moderators of the relationship between BID and depression, while perceived stress acted only as a mediator. High self-esteem and strong social support as well as low levels of perceived stress may help individuals experience lower levels of BID, thereby contributing to a decreased likelihood of depression. Interventions aimed at increasing self-esteem, developing strong support, and decreasing perceived stress may hold promise to reduce the risk of depression in those with BID.
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  • 文章类型: Journal Article
    冒名顶替综合征(IS)和低自尊(SE)是影响医学生的常见问题,可能会影响他们的福祉和发展。这项研究旨在评估Jazan大学医学生中IS和SE的患病率和相关因素。沙特阿拉伯。在这项横断面研究中,在Jazan大学2-6年级的523名医学生,沙特阿拉伯,完成了关于IS(年轻冒名顶替者量表)和SE(罗森博格自尊量表)的验证问卷。还收集了社会人口统计学因素。描述性统计和逻辑回归分析用于分析IS和SE的患病率和相关性。500名23名平均年龄为22.09±1.933的学生参加了比赛。低SE和IS阳性的患病率分别为17.6%和24.3%,分别。IS与SE呈显著负相关(p<0.001)。几个社会人口统计学因素与IS增加有关,包括二年级和四年级学生,强迫学习选择,平均成绩(GPA)为3.0-3.49(P<0.05)。高中以上父亲教育与IS较低相关(P<0.05)。Logistic回归分析证实,二年级学生的比值比(OR)高3.88倍(95%置信区间(CI);2.19-6.88),4年级学生的OR(95%CI;1.40-4.02)比其他年级高2.37倍。对于SE,先进的学术年,强迫学习选择,7小时以上的睡眠,GPA高于3.5与较高水平相关(P<0.05)。负面的自我评估与较低的SE相关,而积极的态度与较高的SE相关(P<0.05)。我们的研究表明,在Jazan大学中,IS和低SE很普遍,沙特阿拉伯,医学生。因此,在Jazan大学的医学教育中解决这些问题的干预课程,沙特阿拉伯,可能是必要的,以支持医学生\的福祉和学业上的成功。
    Imposter syndrome (IS) and low self-esteem (SE) are common issues affecting medical students that can impact their well-being and development. This study aimed to assess the prevalence and factors associated with IS and SE among medical students at Jazan University, Saudi Arabia. In this cross-sectional study, 523 medical students in years 2-6 at Jazan University, Saudi Arabia, completed validated questionnaires on IS (Young Imposter Scale) and SE (Rosenberg Self-Esteem Scale). Sociodemographic factors were also collected. Descriptive statistics and logistic regression analyses were used to analyze IS and SE prevalence and correlates. Five hundred twenty-three students with a mean age of 22.09 ± 1.933 participated. The prevalence of low SE and positive IS was 17.6% and 24.3%, respectively. IS and SE had a significant negative correlation (p<0.001). Several sociodemographic factors were associated with increased IS, including 2nd and 4th-year students, forced study choice, and a grade point average (GPA) of 3.0-3.49 (P<0.05). Paternal education beyond high school was associated with lower IS (P<0.05). Logistic regression analyses confirmed that 2nd-year students had a 3.88 times higher odds ratio (OR) (95% confidence interval (CI); 2.19-6.88), and 4th-year students had a 2.37 times higher OR (95% CI; 1.40-4.02) of IS than other years. For SE, advanced academic years, forced study choice, 7+ hours of sleep, and a GPA above 3.5 were associated with higher levels (P<0.05). Negative self-appraisals were associated with lower SE, while positive attitudes were associated with higher SE (P<0.05). Our study reveals that IS and low SE are prevalent among Jazan University, Saudi Arabia, medical students. Therefore, intervention courses that address these issues in medical education at Jazan University, Saudi Arabia, may be necessary to support medical students\' well-being and academic success.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Editorial
    与身体形象障碍相关的疾病的典型例子是进食障碍(ED),如神经性厌食症(AN)和神经性贪食症(BN),以及身体畸形障碍(BDD)[。..].
    Classical examples of disorders associated with body image disturbances are eating disorders (EDs) such as anorexia nervosa (AN) and bulimia nervosa (BN), as well as body dysmorphic disorder (BDD) [...].
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  • 文章类型: Journal Article
    身体畸形障碍(BDD)由于对身体形象的负面评价而引起痛苦。BDD的发展与社交媒体和照片编辑应用程序的被动使用有关。患有BDD的人通常会进行整容手术以弥补其感知到的缺陷。照片编辑应用程序的使用急剧增加及其对心理健康的既定影响是一个公共卫生问题。
    研究社交媒体的使用与BDD的发展以及沙特人对美容手术(ACSS)的接受度之间的关联。
    在线,横截面,对18岁及以上的沙特人进行了有效的调查。描述性分析用于主要研究变量的人口统计学和患病率。方差分析用于比较不同人口统计学组之间BDD和ACSS的平均得分。当ANOVA检验显示统计学意义时,进行Tukey事后检验以识别不同的类别。P值<0.05被认为是统计学上显著的。
    共有1,483名沙特成年人完成了调查问卷。关键结果表明,在24.4%的样品中发现了BDD。每天在Instagram和Snapchat上花费4-7小时的BDD参与者的百分比(29%)明显高于每天在这些平台上花费不到一个小时的参与者(19%)(p<0.001)。与没有BDD的人相比,患有BDD的人接受整容手术的风险明显更高(p<0.001)。
    越来越多的证据表明,社交媒体可能以不同的方式影响心理健康。这项研究表明,大量使用这些平台与对一个人的外表的负面评价有关,它促进了一个人对整容手术的倾向,尤其是女性。
    Body dysmorphic disorder (BDD) causes distress due to one\'s negative appraisal of their body image. The development of BDD has been linked to the passive use of social media and photo-editing apps. People with BDD typically pursue cosmetic surgeries to remedy their perceived flaws. The dramatic increase in the use of photo-editing apps and their well-established effects on mental health is a public health concern.
    To study the association between use of social media and the development of BDD and acceptance toward cosmetic surgeries (ACSS) among Saudis.
    An online, cross-sectional, validated survey conducted among Saudis 18 and older. Descriptive analyses were utilized for demographics and prevalence rates of main study variables. ANOVA was used to compare mean scores in BDD and ACSS among different demographic groups. Tukeys post-hoc test was done to identify the categories that were different when the ANOVA test showed a statistically significance. A p-value of <0.05 was considered statistically significant.
    A total of 1,483 Saudi adults completed the questionnaire. Key results showed that BDD was found in 24.4 % of the sample. The percentage of participants with BDD who spent 4-7 h per day on Instagram and Snapchat (29%) was significantly higher than those who spent only less than an hour per day on these platforms (19%) (p < 0.001). Individuals with BDD had a significantly higher risk of accepting cosmetic surgery compared to those without BDD (p < 0.001).
    A growing body of evidence suggests that social media may impact mental health in different ways. This study reveals that heavy use of these platforms is associated with negative appraisals about one\'s physical appearance, and it fosters one\'s tendency toward cosmetic surgery, especially among females.
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  • 文章类型: Randomized Controlled Trial
    背景:身体畸形障碍(BDD)是一种严重的,慢性疾病,如果不治疗。BDD的智能手机认知行为疗法(CBT)是有效的,可以减少关键的治疗障碍(例如,缺乏临床医生,成本,污名)。虽然有希望,人们对谁或多或少可能从这种方法中受益知之甚少。
    方法:这是随机,Waitlist控制的BDD智能手机CBT试验。参与者(N=80)在全国范围内招募并随机接受12周,教练指导的CBT为BDD应用程序,立即或在12周的候补名单之后。此分析的主要结果是BDD严重程度(BDD-YBOCS)随时间(基线,第6周,第12周)在每个随机组的主动应用使用阶段(n=74)。次要结果包括治疗反应(BDD-YBOCS降低≥30%)和治疗结束时缓解(总BDD-YBOCS≤16)。
    结果:立即(与延迟)CBT预测更好的结果(症状改善),性别认同(症状改善)也是如此,更高的基线治疗可信度和预期(反应,缓解),较低的基线BDD严重程度(缓解),和性少数群体地位(vs.异性恋;反应,residence).
    结论:限制包括相对较小的样本,辍学率为22%,有限的性别和种族种族多样性。
    结论:这些结果凸显了智能手机CBT在历史边缘化人群中的潜在优势,以及加快获得治疗的努力的重要性,在治疗开始时增强对治疗的信心,并开发分层护理模式,以优化治疗分配和疗效。
    BACKGROUND: Body dysmorphic disorder (BDD) is a severe, chronic disorder if untreated. Smartphone cognitive behavioral therapy (CBT) for BDD is efficacious and can reduce key treatment barriers (e.g., lack of clinicians, cost, stigma). While promising, little is known about who is more or less likely to benefit from this approach.
    METHODS: This is a secondary data analysis of a randomized, waitlist-controlled trial of smartphone CBT for BDD. Participants (N = 80) were recruited nationally and randomized to receive a 12-week, coach-guided CBT for BDD app, either immediately or after a 12-week waitlist. The main outcome for this analysis was BDD severity (BDD-YBOCS) over time (baseline, week 6, week 12) during the active app use phase in each randomized group (n = 74). Secondary outcomes included treatment response (≥30 % reduction in BDD-YBOCS) and remission (total BDD-YBOCS ≤16) at end-of-treatment.
    RESULTS: Immediate (vs. delayed) CBT predicted better outcomes (symptom improvement), as did gender identity (symptom improvement), higher baseline treatment credibility and expectancy (response, remission), lower baseline BDD severity (remission), and sexual minority status (vs. heterosexual; response, remission).
    CONCLUSIONS: Limitations include the relatively small sample, drop-out rate of 22 %, and limited gender and racial-ethnic diversity.
    CONCLUSIONS: These results highlight a potential advantage of smartphone CBT in historically marginalized populations, and the importance of efforts to hasten treatment access, bolster confidence in the treatment at treatment onset, and develop stratified care models to optimize treatment allocation and efficacy.
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  • 文章类型: Journal Article
    身体畸形障碍(BDD)是中东国家未充分开发的精神疾病,特别是在有皮肤病学问题的患者中,外观改变可能会增加BDD的风险。我们从2022年7月至9月在约旦大学医院的普通皮肤科和美容诊所对患者进行了研究,并将其与健康对照进行了比较。根据国际疾病分类(ICD-10)标准,由训练有素的皮肤科医生评估患有皮肤病的患者。所有参与者都完成了病态关注问卷(DCQ),感知压力量表,患者健康问卷-2,一般焦虑症评估工具-2。我们使用四个DCQ截止值:9、11、14和17来评估BDD患病率,并将效应大小报告为比值比(OR)。我们的研究涉及1500名参与者,平均年龄为29.3(±14.8)岁,男女比例为3.15:1。在9、11、14和17DCQ截止时间,BDD患病率为78.2%,54.2%,26.5%,和11.7%,分别。在11截止时,有皮肤病学问题的患者比对照组更有可能出现临床BDD症状(OR:1.26;95%CI1.01-1.58;p<0.05)。相反,在截止时间9(OR:2.26;95%CI1.28-3.97;p<0.05)和11(OR:1.50;95%CI1.03-2.20;p<0.05)时,有美容问题的患者比对照组更容易发生临床BDD.我们的逻辑回归显示,较高的DCQ评分与焦虑升高之间存在一致的关联,抑郁症,感知到与皮肤病相关的污名,并降低生活质量(p<0.05)。总之,有皮肤病问题的患者和寻求整容手术的患者有发生BDD的重大风险,由于相关的心理困扰和无效的咨询,需要皮肤科医生进行主动筛查和转诊以进行专门护理。为医疗保健专业人员提供专门的培训,以建立综合护理方法来满足BDD患者的需求,应该是未来研究项目的重点。
    Body Dysmorphic Disorder (BDD) is an underexplored psychiatric condition in Middle Eastern countries, particularly in patients with dermatologic concerns, where alterations in appearance may elevate the risk of BDD. We studied patients at Jordan University Hospital\'s general dermatology and cosmetic clinics from July to September 2022, comparing them to healthy controls. Patients with dermatologic conditions were evaluated per the International Classification of Diseases (ICD-10) criteria by trained dermatologists. All participants completed the Dysmorphic Concerns Questionnaire (DCQ), Perceived Stress Scale, Patient Health Questionnaire-2, General Anxiety Disorder Assessment tool-2. We assessed BDD prevalence using four DCQ cutoffs: 9, 11, 14, and 17, reporting effect sizes as odds ratios (OR). Our study involved 1500 participants, with an average age of 29.3 (± 14.8) years and a female-to-male ratio of 3.15-to-1. At the 9, 11, 14, and 17 DCQ cutoffs, BDD prevalence was 78.2%, 54.2%, 26.5%, and 11.7%, respectively. Patients with dermatologic concerns were more likely to exhibit clinical BDD symptoms than controls at the 11-cutoff (OR: 1.26; 95% CI 1.01-1.58; p < 0.05). Conversely, those with cosmetic concerns were more prone to clinical BDD than controls at cutoffs 9 (OR: 2.26; 95% CI 1.28-3.97; p < 0.05) and 11 (OR: 1.50; 95% CI 1.03-2.20; p < 0.05). Our logistic regression revealed consistent associations between higher DCQ scores and elevated anxiety, depression, perceived skin disease-related stigma, and reduced quality of life (p < 0.05). In conclusion, patients with dermatologic issues and those seeking cosmetic procedures are at significant risk of developing BDD, necessitating proactive screening and referrals for specialized care by dermatologists due to the associated psychological distress and unproductive consultations. Providing specialized training for healthcare professionals to establish an integrated care approach to address the needs of patients with BDD should be the focus of future research projects.
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