Body Image：躯体变形障碍患者不宜做整形手术

每个人都希望自己看上去更漂亮、更年轻、更健康。人们对完美相貌的渴望使得整形外科及皮肤美容手术越来越流行。对此，医学专家们不无担心，他们认为，有些人不适合做整形外科或皮肤美容手术，尤其是躯体变形障碍患者。躯体变形障碍是个体为想象缺陷而痛苦的神经症(或躯体化症)，是一种与美容医学关系十分密切的心理异常现象。最新一期爱思唯尔期刊《体象》（Body Image）对患躯体变形障碍的人实施整形美容手术的害处进行了深入探讨。

打算做整形外科的人往往对自己的外貌有不满意的地方，这使得对手术者是否患有躯体变形障碍的判断变得更加困难。但一般来说，这些人要么是过分关注自己外貌的某个“轻微的”或“想象中的”缺陷，要么是因为对自己的外貌的不满而陷入深深的痛苦之中。此外，患有躯体变形障碍的人更加频繁地尝试用美容手术让自己更漂亮。

有研究显示，在尝试整形外科手术的人当中，大约有百分之5至15患有躯体变形障碍。而整形外科手术对躯体变形障碍患者的病情没有任何改善。

因此，整形美容医生应该在实施整形手术之前，对手术对象进行评估，判定他（她）是否患有躯体变形障碍，是否适合做整形手术。相应的，患有躯体变形障碍的人不应该进行整形手术，而应求助心理医生解除自己的痛苦。（科学网荔涛/编译）

生物谷推荐原始出处：

Body Image，doi:10.1016/j.bodyim.2007.08.003，David B. Sarwer and Canice E. Crerand

Body dysmorphic disorder and appearance enhancing medical treatments

David B. Sarwer^a^,^, and Canice E. Crerand^b

^aDepartments of Psychiatry and Surgery, Center for Weight and Eating Disorders and the Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania School of Medicine, 10 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, United States

^bThe Children's Hospital of Philadelphia, Department of Psychology, Division of Plastic Surgery, The Edwin and Fannie Gray Hall Center for Human Appearance, United States

Abstract

This article reviews the literature on body dysmorphic disorder (BDD) in persons who seek appearance enhancing medical treatments such as cosmetic surgery and dermatological treatment. We begin with a discussion of the growing popularity of cosmetic surgical and minimally invasive treatments. The literature investigating the psychological characteristics is briefly highlighted. Studies investigating the rate of BDD among persons who seek appearance enhancing treatments are detailed and, collectively, suggest that approximately 5–15% of individuals who seek these treatments suffer from BDD. Retrospective reports suggest that persons with BDD rarely experience improvement in their symptoms following these treatments, leading some to suggest that BDD is a contraindication to cosmetic surgery and other treatments. The clinical management of patients with BDD who present for these treatments is briefly described and directions for future research are provided.