הסקירה באדיבות אתר מדיקונטקסט:By Pat Hagan
LONDON (Reuters Health) – Patients who have plastic surgery because they think they are ugly may be better off taking antidepressants or undergoing psychotherapy.
New research from Australia suggests that patients with dysmorphic concern, or "imagined ugliness," are rarely happy with the outcome of surgery, even if the procedure is a success. The findings were presented here this week by Dr. Stephen Kisely, of Fremantle Hospital, in Western Australia, at the annual meeting of the Royal College of Psychiatrists.
Dr. Kisely's group also found that patients who are unhappy with their bodily features suffer higher levels of psychological distress than those who have been scarred or damaged as a result of trauma or disease.
There is mounting evidence that dysmorphic concern patients can be persuaded not to have surgery if physicians can treat the symptoms of distress, Dr. Kisely told Reuters Health.
"These patients will happily acknowledge that they are distressed, or that their condition gets them down. But they would never acknowledge that it's all in their mind. So the spin the doctor has to put on it is that they will treat the symptoms while the patient is waiting for surgery. In my experience it works," he said.
Dr. Kisely and colleagues studied 84 patients, of whom half wanted the surgery for cosmetic reasons and half needed it for medical reasons. Using special questionnaires to measure their general health and their perceptions of their own bodies, the researchers were able to pinpoint the exact motives for the surgery.
Patients wanting cosmetic surgery were 13 times more likely to be female and 6 times more likely to have a high score on the dysmorphic concern questionnaire.
"We should encourage GPs to use the questionnaires as a screening tool to avoid inappropriate referrals. Selective serotonin reuptake inhibitors and cognitive behaviour therapy can be effective treatments for dysmorphic concern," Dr. Kisely said.
He told Reuters Health that there might also be a link between this condition and obsessive-compulsive disorder, which some experts believe is affected by disruption of serotonin. "The antidepressants actually help take the edge off recurring thoughts and concerns. It helps patients get things into perspective and then they might decide they don't need surgery after all," he said.
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