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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Impact of Facial Atrophic Acne Scars on Quality of Life: A Multi-country Population-Based Survey. Am J Clin Dermatol 2022; 23:115-123. [PMID: 34705166 PMCID: PMC8776674 DOI: 10.1007/s40257-021-00628-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
Background Acne affects more than 80% of adolescents and young adults, who most often develop acne scars. Supporting data on the effect of acne scars on patient’s health-related quality of life (HRQOL) are limited. Objective The aim was to determine how the severity of acne scars impacts the HRQOL of afflicted individuals. Methods In this population-based cross-sectional study, 723 adults with facial acne scars but without active acne lesions self-completed the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire formulated to investigate degree of acne scarring. The Facial Acne Scar Quality of Life (FASQoL), Dermatology Life Quality Index (DLQI), and Dysmorphic Concern Questionnaire (DCQ) were completed to assess the attitude of these patients toward their scars and the impact of scarring on their HRQOL. Results The mean (standard error) DLQI score for facial acne scars was 6.26 (0.22). Acne scars were considered a ‘very large’ or ‘extremely large’ concern by 19.3% of participants with mild scars as compared to 20.1% and 34.0% of participants with moderate and severe/very severe scars, respectively (P = 0.003). Higher FASQoL scores were associated with increased severity of scarring (P = 0.001). In total, 16.9% of participants had clinical features of dysmorphia (i.e., DCQ > 13). DCQ scores were significantly higher among participants with more severe scarring (mean DCQ score of 8.04 [0.28], 8.40 [0.18], and 10.13 [0.08] among participants with mild, moderate, and severe/very severe acne scars, respectively; P = 0.001). Most commonly reported signs of emotional distress were self-consciousness (68.0%) and worry about scars not going away (74.8%). Conclusions This study highlights the significant psychosocial impact of atrophic acne scars in the form of embarrassment and self-consciousness. Individuals with mild scars also expressed significant impact on quality of life that increased with aggravation of scar severity. Patient-reported outcomes provide an insight into the physical, functional, and psychological impact of acne scarring from the patient’s perspective. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-021-00628-1.
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Affiliation(s)
- Jerry Tan
- , 2224 Walker Road, Suite 300, Windsor, ON, N8W 5L7, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Fran Cook-Bolden
- Mount Sinai Department of Dermatology, 5 East 98th Street, New York, NY, 10029, USA
| | - Rajeev Chavda
- GALDERMA, Rue d'Entre-deux-Villes 10, 1814, La Tour-de-Peilz, Switzerland
| | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, 2470 Rocky Ridge Rd # 100, Vestavia Hills, AL, 35243, USA
| | - Adelaide Hebert
- The University of Texas Medical School-Houston, 6655 Travis, Suite 980, Houston, TX, 77030, USA
| | - Edward Lain
- Austin Institute for Clinical Research, 1601 E Pflugerville Pkwy Suite 1101, Pflugerville, TX, USA
| | - Alison Layton
- Hull York Medical School, University Rd, Heslington, YO10 5DD, York, UK
| | - Marco Rocha
- Federal University of São Paulo, R. Sena Madureira, 1500-Vila Clementino, São Paulo, SP, 04021-001, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners, (Formerly, Gwinnett Dermatology, PC), 2383 Pate St., N, Snellville, GA, 30078, USA
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, CHU Nantes-Place Alexis Ricordeau, 44093, Nantes Cedex 01, France.
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Face-to-Face and Cyber-Victimization: A Longitudinal Study of Offline Appearance Anxiety and Online Appearance Preoccupation. J Youth Adolesc 2021; 50:2311-2323. [PMID: 33449288 DOI: 10.1007/s10964-020-01367-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
Abstract
Most adolescents and young adults navigate seamlessly between offline and online social environments, and interactions in each environment brings with it opportunities for appearance concerns and preoccupation, as well as victimization and teasing about appearance. Yet, research has concentrated primarily on face-to-face victimization and its role in offline appearance anxiety symptoms in adolescents and young adults. To extend this to include cyber-victimization and online behaviors indicative of appearance anxiety, the present longitudinal study investigated the risk of face-to-face and cyber-victimization for offline appearance anxiety and online appearance preoccupation. Participants were 650 adolescents age 15 to 19 years (Mage = 17.3 years, 59% female) who completed two surveys over one-year. Correlations identified both forms of victimization as associated with offline appearance anxiety and online appearance preoccupation. Yet, in a structural equation model, face-to-face peer victimization, but not cyber-victimization, was uniquely associated with increased offline appearance anxiety and online appearance preoccupation from T1 to T2. Offline appearance anxiety and online appearance preoccupation strongly covaried and were bidirectionally associated over time. Female gender and age were associated with more anxiety and preoccupation. When gender moderation was tested, only the stability in appearance anxiety was moderated, with greater stability in females than males. Overall, offline and online appearance anxieties are highly interrelated and share a common risk factor in face-to-face appearance-related victimization by peers.
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Aouizerate B, Pujol H, Grabot D, Faytout M, Suire K, Braud C, Auriacombe M, Martin D, Baudet J, Tignol J. Body dysmorphic disorder in a sample of cosmetic surgery applicants. Eur Psychiatry 2020; 18:365-8. [PMID: 14643566 DOI: 10.1016/j.eurpsy.2003.02.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AbstractBody dysmorphic disorder (B.D.D.) consists of a preoccupation with an imagined or slight physical defect. This study is the first European report on prevalence and several clinical and functional characteristics of patients with B.D.D. in a cosmetic surgery setting. Comparisons with defect- and severity-matched subjects without B.D.D. were also performed.
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Affiliation(s)
- B Aouizerate
- Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier Charles Perrens, Université Victor Segalen (Bordeaux 2), Centre Carreire, 121, rue de la Béchade, 33076 cedex, Bordeaux, France
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4
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James M, Clarke P, Darcey R. Body dysmorphic disorder and facial aesthetic treatments in dental practice. Br Dent J 2019; 227:929-933. [PMID: 31758136 DOI: 10.1038/s41415-019-0901-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a relatively high prevalence of body dysmorphic disorder (BDD) and it is known that this patient group regularly and frequently visit dental practitioners, especially those who advertise themselves as cosmetic or aesthetic practices. The market for facial aesthetics is hugely increasing both generally and within dental practices making it ever more likely that dentists will encounter this patient group frequently. Moreover, due to the nature of their concerns individuals within this group are likely to have contact with dentists (or other medical professionals in the physical health field) prior to any contact with mental health professionals. The aim of this paper is to give an overview of the presentation of BDD, to discuss the changing climate of facial aesthetic treatments and to highlight a care pathway for general dentists. Identification of patients with potential BDD is far more predictable with the use of a validated questionnaire, and the BDD Questionnaire and Dysmorphic Concern Questionnaire are described. A flowchart approach for the management of patients requesting aesthetic improvements is presented as the ideal method for identifying, referring and managing the aesthetic treatment desires of potential BDD patients.
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Affiliation(s)
- Martin James
- Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester, Manchester Universities NHS Foundation Trust, Manchester, UK.
| | - Peter Clarke
- Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester, Manchester Universities NHS Foundation Trust, Manchester, UK
| | - Rebecca Darcey
- Clinical Psychologist, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Tripathi A, Avasthi A, Grover S, Sharma E, Lakdawala BM, Thirunavukarasu M, Dan A, Sinha V, Sareen H, Mishra KK, Rastogi P, Srivastava S, Dhingra I, Behere PB, Solanki RK, Sinha VK, Desai M, Reddy YCJ. Gender differences in obsessive-compulsive disorder: Findings from a multicentric study from India. Asian J Psychiatr 2018; 37:3-9. [PMID: 30086467 DOI: 10.1016/j.ajp.2018.07.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
Obsessive-compulsive disorder (OCD) is phenotypically heterogeneous. Gender is an important factor mediating this heterogeneity. We examined gender differences in a large sample (n = 945) of OCD patients under a multi-centric study in India. Cross-sectional assessments were done on consecutive adult (>18 years) treatment-seeking patients with a DSM-5 diagnosis of OCD. Subjects were assessed on Structured Clinical Interview for DSM-5-Research Version for comorbid psychiatric illnesses, Yale Brown Obsessive Compulsive Scale for OCD phenomenology and symptom severity, Brown Assessment of Beliefs Scale for insight, Beck's Depression Inventory for severity of depressive symptoms, and the Obsessive Beliefs Questionnaire. On multivariate backward Wald logistic regression analysis, males (59.7%) had more years of education, had a higher rate of checking compulsions and comorbid substance use disorders. Women were more likely to be married, more commonly reported precipitating factors, had a higher rate of hoarding compulsions and comorbid agoraphobia. Findings from this large study validate gender as an important mediator of phenotypic heterogeneity in OCD. The mechanistic basis for these differences might involve complex interactions between biological, cultural and environmental factors.
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Affiliation(s)
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Eesha Sharma
- National Institute of Mental Health and Neurosciences, Bangalore, India.
| | | | - M Thirunavukarasu
- SRM Medical College Hospital & Research Center, Kattankulathur, Kanchipuram District, 603203, India
| | | | | | | | | | - Pali Rastogi
- MGM Medical College & MYH Hospital, Indore, India
| | - Shruti Srivastava
- University College of Medical Sciences and GTBH, Dilshad Garden, Delhi, India
| | | | - Prakash B Behere
- Dr D.Y. Patil University Kasba Bawda, Kolhapur 416006, Maharashtra, India
| | | | - Vinod K Sinha
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Mahesh Desai
- Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka India
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6
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SantaBarbara NJ, Whitworth JW, Ciccolo JT. A Systematic Review of the Effects of Resistance Training on Body Image. J Strength Cond Res 2017; 31:2880-2888. [PMID: 28723817 DOI: 10.1519/jsc.0000000000002135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this systematic review was to identify and appraise the literature that has specifically tested the independent effects of resistance training (i.e., weightlifting) on body image in adults. A comprehensive search of electronic databases PubMed, Scopus, PsycNET, and Web of Science for relevant studies published in peer-reviewed journals through December 2016 was conducted, and PRISMA guidelines were followed. Inclusion criteria were that a study had to be (a) written in English, (b) published in a peer-reviewed journal, (c) conducted an assessment of body image using a validated scale before and after a stand-alone resistance training intervention (i.e., not coupled with another mode of treatment), and (d) excluded participants younger than 18 years. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. A total of 7,324 studies were identified, and 11 were included in this review. The majority (8 of 11) of studies concluded that resistance training can significantly improve multiple dimensions of body image, including body satisfaction, appearance evaluation, and social physique anxiety; however, only 3 studies were considered high quality based on their PEDro score, and several methodological limitations exist. Overall, resistance training seems to have the potential to improve body image in adults, but future high-quality studies with more rigorous testing methods and study designs are needed.
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Affiliation(s)
- Nicholas J SantaBarbara
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York
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7
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Chapuis-de-Andrade S, de Araujo RM, Lara DR. Association of weight control behaviors with body mass index and weight-based self-evaluation. ACTA ACUST UNITED AC 2017; 39:237-243. [PMID: 28355342 PMCID: PMC7111379 DOI: 10.1590/1516-4446-2016-2038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/30/2016] [Indexed: 11/22/2022]
Abstract
Objective: To determine the frequency of weight control behaviors (WCBs) and their correlation with body mass index (BMI) and weight-based self-evaluation. Methods: Data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from 27,501 volunteers (30.4% men, mean age 28.9±8.7 years). Results: The most prevalent WCBs for men and women were exhaustive physical exercise and prolonged fasting, respectively. Frequent exhaustive physical exercise was the only behavior more often adopted by men. BMI was positively associated with WCBs, which were very frequent in obese subjects. About 15% of normal-weight women reported using diuretics and laxatives, and 12.2% reported vomiting as a WCB at least occasionally. Among subjects who regarded body weight highly in their self-evaluation, there was a strong positive association with all WCBs, at similar degrees, in both genders. Compared to those who never base their intrinsic personal value on body weight, those who frequently base intrinsic value on body weight were at 25-30 times higher risk of inducing vomiting. Conclusion: The prevalence of participants adopting WCBs was high, especially in women and obese subjects. Weight-based self-evaluation was more strongly associated with WCBs than BMI.
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Affiliation(s)
- Sabrina Chapuis-de-Andrade
- Faculdade de Biociências e de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Rafael M de Araujo
- Faculdade de Biociências e de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Diogo R Lara
- Faculdade de Biociências e de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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8
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Diehl BJ, Baghurst T. Biopsychosocial factors in drives for muscularity and muscle dysmorphia among personal trainers. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1243194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Beau James Diehl
- Andromeda Psychological Coaching and Research Solutions, LLC, Traverse City, MI 49685, USA
| | - Timothy Baghurst
- Health and Human Performance, Oklahoma State University, Stillwater, OK 74074, USA
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9
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Phillipou A, Blomeley D, Castle DJ. Muscling in on body image disorders: What is the nosological status of muscle dysmorphia? Aust N Z J Psychiatry 2016; 50:380-1. [PMID: 26553220 DOI: 10.1177/0004867415615951] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Phillipou
- Department of Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia Department of Psychiatry, The University of Melbourne, Parkville VIC, Australia Department of Mental Health, The Austin Hospital, Heidelberg, VIC, Australia
| | | | - David J Castle
- Department of Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia Department of Psychiatry, The University of Melbourne, Parkville VIC, Australia Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
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10
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Abstract
The aim of this study was to examine the influence of yoga practice on body image satisfaction in men. Male Figure Drawings were used to explore body image satisfaction in yoga beginners ( n = 26, M age = 40.3yr., SD = 11.6), experienced yoga practitioners ( n = 22, M age = 46.4yr., SD = 11.6), and non-yoga practicing aerobic and weight training exercisers ( n = 34, M age = 41.2yr., SD = 11.9). Satisfaction was significantly higher among the yoga groups than the exercisers. There was no statistical difference between the body satisfaction scores of the experienced yoga group and the beginner yoga students. This may suggest that individuals drawn to yoga have greater body satisfaction than exercisers, and that regular yoga practice possibly further increases body satisfaction.
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Affiliation(s)
- Mary Flaherty
- School of Psychology and Social Science, Edith Cowan University
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11
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Eriksen TE, Kirkengen AL, Vetlesen AJ. The medically unexplained revisited. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2013; 16:587-600. [PMID: 23054425 DOI: 10.1007/s11019-012-9436-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Medicine is facing wide-ranging challenges concerning the so-called medically unexplained disorders. The epidemiology is confusing, different medical specialties claim ownership of their unexplained territory and the unexplained conditions are themselves promoted through a highly complicated and sophisticated use of language. Confronting the outcome, i.e. numerous medical acronyms, we reflect upon principles of systematizing, contextual and social considerations and ways of thinking about these phenomena. Finally we address what we consider to be crucial dimensions concerning the landscape of unexplained "matters"; fatigued being, pain-full being and dys-ordered being, all expressive momentums of an aesthetic of resistance.
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Affiliation(s)
- Thor Eirik Eriksen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway.
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12
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Abstract
Apotemnophilia is a condition where sufferers wish to be an amputee. Currently, belief in the medical profession is that it is part of the spectrum of body dysmorphic disorder and as such patients are denied surgical correction. This can lead sufferers to extreme lengths. Proponents seek to have the disorder reclassified to a body identity integrity disorder such as gender identity disorder. In this way treatment modalities could be reassessed.
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13
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Darko N. “Get up, shut up and stop being a fanny”: Rugby Union men and their suppression of body anxiety. JOURNAL OF MENS HEALTH 2009. [DOI: 10.1016/j.jomh.2009.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hassan J, Grogan S, Clark-Carter D, Richards H, Yates VM. The individual health burden of acne. J Health Psychol 2009; 14:1105-18. [DOI: 10.1177/1359105309342470] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined appearance-related distress in patients with acne. One hundred and thirty-two people attending a specialist acne clinic completed questionnaires including the Derriford Appearance Scale and three self-rated acne scales covering more (facial) and less visible (chest, back) acne sites. Women with acne demonstrated greater self-consciousness of appearance and negative self-concept than men. Subjective rating of severity of facial acne was significantly associated with increased social self-consciousness in women, but not in men. Back acne was significantly associated with sexual and bodily self-consciousness of appearance in both men and women. Patients 20 years and above were significantly more likely to suffer appearance-related distress than 16—19-year-olds. Although not a key focus of this study, ethnicity was also implicated in appearance concern arising from acne.
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Quaglio G, Fornasiero A, Mezzelani P, Moreschini S, Lugoboni F, Lechi A. Anabolic steroids: dependence and complications of chronic use. Intern Emerg Med 2009; 4:289-96. [PMID: 19468827 DOI: 10.1007/s11739-009-0260-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 04/22/2009] [Indexed: 02/08/2023]
Abstract
Anabolic steroids are widely used for doping, in professional and domestic sports. The mechanism of action is not completely understood. It may differ somewhat depending on the specific molecule due to structural differences that influence the specificity of binding with steroid receptors. When used by athletes in training, they can improve performance to levels that cannot be attained by almost any combination of sophisticated nonchemical support by modern sport science. The severity of the undesired effects of anabolic steroids depends on a variety of factors, from the type and combination of them, the dose and duration of administration, as well as the gender of the person taking the drug. Younger individuals and women show greater effects caused by anabolic steroids in terms of performance, but are also at greater risk of side effects. This paper presents a review of the literature concerning the major adverse effects of anabolic steroids, focusing the attention on possible situations of addiction from this category of drugs.
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Affiliation(s)
- Gianluca Quaglio
- Section of Internal Medicine and Addictive Disorders, Department of Biomedical Sciences, University of Verona, Ospedale Policlinico, Piazza L. A. Scuro, 37134 Verona, Italy
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Abstract
BACKGROUND Body dysmorphic disorder (BDD) is defined as a syndrome characterized by an excessive preoccupation because of a presumed or minimal physical flaw in appearance that polarizes the energies of the subject. So far, its specular aspect, represented by the presence of an evident physical defect that is not recognized or is even denied and neglected, has been disregarded. The aim of our study was to examine the individual and relational meaning of BDD and to evaluate the efficacy of cognitive-behavioral and medical-aesthetical treatments. METHODS AND RESULTS We describe two subjects with BDD, diagnosed by clinical interviews and test. Both patients were compliant to cognitive-behavioral approach. One out of two subjects underwent aesthetical treatments. CONCLUSIONS Cognitive-behavioral therapy stimulates self-consciousness, rebuilds the body image, promotes health care, and improves relational capacity. Moreover, it ensures the success of any medical and/or surgical procedures by preventing unrealistic expectations. Lastly, it contributes to the definition of worldwide shared behavioral models.
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Sardinha A, Oliveira AJD, Araújo CGSD. Dismorfia muscular: análise comparativa entre um critério antropométrico e um instrumento psicológico. REV BRAS MED ESPORTE 2008. [DOI: 10.1590/s1517-86922008000400013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Os transtornos psiquiátricos relacionados à distorção da auto-imagem corporal são marcados por elevado grau de sofrimento físico e psíquico, associado a perdas sociais e ocupacionais significativas, além de produzirem comportamentos danosos para a saúde física do paciente. A dismorfia muscular (DISMUS) é um subtipo do transtorno dismórfico corporal, que se caracteriza por uma preocupação específica com o tamanho do corpo e com o desenvolvimento dos músculos. É um transtorno presente quase exclusivamente em homens que, apesar da visível hipertrofia, procuram ativamente aumentar sua massa muscular, através de exercícios excessivos, do uso de substâncias ergogênicas e de dietas hiperprotéicas. O presente estudo teve como objetivo avaliar a validade de constructo de um critério antropométrico (Índice B/P - relação entre a perimetria do braço contraído e da perna), anteriormente proposto, para suspeita diagnóstica de DISMUS. Uma amostra (n = 100) de homens, praticantes de treinamento de força, com idade entre 18 e 35 anos, teve suas medidas antropométricas comparadas os os escores obtidos em uma escala usada para o diagnóstico da DISMUS (MASS - Muscle Appearance Satisfaction Scale) e também com as medidas de um grupo de indívíduos de características semelhantes, avaliados com o objetivo de obter orientação para a prática de exercícios físicos (n = 313). A análise dos resultados indica que um indivíduo com índice B/P > 1 possuem alta probabilidade de apresentar um escore indicativo de DISMUS no instrumento MASS e sugere ser coerente a aplicação do índice B/P como um indicador antropométrico válido para o diagnóstico de DISMUS. O critério B/P pode ser um potente instrumento usado por profissionais da área de exercício para auxiliar no diagnóstico e tratamento precoce desses indivíduos.
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Abstract
The male is often troubled by concerns that his penis is not large enough to satisfy his partner or himself. He is ashamed to have others view his penis, especially in the flaccid state. Such concerns might be unfounded in reality and might be a presentation of social anxiety or some other clinical problem, such as erectile dysfunction. Concern over the size of the penis, when such concern becomes excessive, might present as the 'small penis syndrome', an obsessive rumination with compulsive checking rituals, body dysmorphic disorder, or as part of a psychosis. However, it is often a worry that can be described as within the normal experience of many men. Various potential causal factors are considered. A thorough assessment, normalizing the worry and then exploring the treatment options in detail with the man, is essential to allow the matter to be consolidated satisfactorily within the male ego.
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Affiliation(s)
- Kevan R Wylie
- Porterbrook CLinic, Sheffield Care Trust, Sheffield, UK.
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19
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Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a syndrome characterized by distress secondary to imagined or minor defects in one's appearance. Although it is a psychiatric disorder, most affected patients present to the dermatologist or plastic surgeon to improve their perceived defect. OBJECTIVE The objective was to review the literature on BDD, examining the epidemiology, etiology, clinical features, diagnostic criteria, and treatment of the disorder. METHODS Three representative cases of BDD are presented; in addition, a search of MEDLINE was completed and a review of all published data on BDD was performed. RESULTS BDD has an estimated prevalence of 1 to 2% in the general population; this prevalence is increased in patient populations. There is significant comorbidity associated with BDD. CONCLUSIONS BDD is a relatively common psychiatric disorder in which patients typically present to cosmetic surgeons for treatment of their perceived or imagined defect. Surgical treatments usually prove unsatisfactory to the patient and to the practitioner. Psychiatric treatment is extremely challenging.
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Affiliation(s)
- Christine L Mackley
- Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
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20
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Abstract
Body dysmorphic disorder (BDD) is defined as a preoccupation with an "imagined" defect in one's appearance. Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive. The preoccupation is associated with many time consuming rituals such as mirror gazing or constant comparing. BDD patients have a distorted body image, which may be associated with bullying or abuse during childhood or adolescence. Such patients have a poor quality of life, are socially isolated, depressed, and at high risk of committing suicide. They often have needless dermatological treatment and cosmetic surgery. The condition is easily trivialised and stigmatised. There is evidence for the benefit of cognitive behaviour therapy and selective serotonin reuptake inhibitors in high doses for at least 12 weeks, as in the treatment of obsessive-compulsive disorder. There is no evidence of any benefit of antipsychotic drugs or other forms of psychotherapy.
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Affiliation(s)
- D Veale
- Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University of London, London, UK.
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21
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Abstract
In this review, some aspects of functional gastrointestinal disorders are described, with particular reference to psychiatric and psychological features. Seven syndromes or conditions, which may present not uncommonly in a gastroenterology clinic, are identified and clarified. Thereafter, the roles of a psychiatrist and other mental health professionals (psychotherapists, psychologists) within gastroenterology are described, with particular reference to what an integrated service may offer.
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Affiliation(s)
- J M Stern
- St Mark's Hospital, Harrow, Middlesex, UK.
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22
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