Transtorno dismórfico corporal em candidatos à abdominoplastia reparadora após grandes perdas ponderais: estudo de rastreamento e proposta de minicurso para profissionais de saúde na modalidade EAD

Abstract

Introduction: The concern of a large part of the population with body appearance has increased greatly since exposure on social networks became extremely frequent, which increased the level of demand for the final result of aesthetic plastic surgeries. With the increase in the prevalence of obesity in Brazil, as well as in the number of bariatric surgeries and plastic surgeries to redefine body contour, an extrapolation of this phenomenon has also been observed in the field of reconstructive surgeries. However, the fine line that divides very demanding patients from those with a pathological demand resulting from the presence of a psychiatric disorder as a background, Body Dysmorphic Disorder is still unclear. In theory, it is inferred that the prevalence of BDD symptoms is higher and that they are more severe in patients undergoing reconstructive plastic surgery than in those operated for aesthetic reasons, especially in patients with signs of anxiety and depression. This becomes quite evident when we analyze the flow of patients seen at the body contour redefinition outpatient clinic for post-bariatric patients treated at the Hospital Regional da Asa Norte (HRAN), in Brasília-DF, where I have worked as a plastic surgeon since 2021. Aims: To describe the prevalence of BDD symptoms in patients who wish to undergo reconstructive abdominoplasty after major weight loss, with the purpose of developing a mini-diagnostic course for plastic surgeons in the distance learning modality to assist in the identification of patients with this psychiatric disorder; to identify the proportion of patients with BDD symptoms in the study population; to explore possible factors associated with the presence of BDD symptoms; determine the level of anxiety and depression in the patients studied using a specific instrument (HAD Scale – Annex A); determine the self-perception of body image of the patients studied using a specific instrument (BDDE – Annex B); evaluate the correlation between the HAD scale and the diagnostic criteria for BDD according to the DSM-IV; evaluate the correlation between the BDDE and the diagnostic criteria for BDD according to the DSM-IV. Products Developed: Product 1 (Manuscript) – Prevalence of Body Dysmorphic Disorder in Patients Candidates for Reconstructive Abdominoplasty after Major Weight Loss; submitted for evaluation in the journal Arquivos Brasileiros de Cirurgia Digestiva (ISSN 2317-6326 Qualis A4). Product 2 (Technical/Technological) – Online course to train health professionals on Body Dysmorphic Disorder (to be made available in the EAD format in the virtual learning environment of the Federal District School of Public Health/FEPCS). This project is aligned with the research line of Quality in Health Care for Adults and the Elderly. Conclusions: A high prevalence of body dysmorphia was found in the studied population (63%), especially among younger individuals. Body Dysmorphic Disorder was strongly associated with both anxiety and depression. We emphasize that the method used in this work is adequate and innovative. The work has the potential to influence public policies and practices related to the health area, is innovative, presents originality and relevance for scientific and technological development linked to health and has the capacity to return the results to both the scientific community and health authorities. The technical production developed has the potential to generate a high impact in solving a problem previously identified in a public hospital belonging to the Health Department of the Federal District and has national applicability.