Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro

Detalhes bibliográficos
Autor(a) principal: Ribeiro, Fernanda Dias
Data de Publicação: 2019
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
Texto Completo: https://tede2.pucsp.br/handle/handle/22648
Resumo: Body dysmorphic disorder from Brazilian plastic surgeon’s optic. On a scenario where the reinless search for beauty ideals is observed, associated with the ascending panorama of plastic surgery, the body dysmorphic disorder (BDD) stands out as a psychiatric disorder of high prevalence between patients that seek for cosmetic treatments, frequently serious, underdiagnosed and underreported. The BDD is defined as an excessive preoccupation about a minimal or imperceptive flaw for other people. That excessive concern causes significative clinical suffering or social, occupational or any other important functioning area impairment. The BDD is also associated with poor quality of life, which may lead to high rates of suicidal ideation and even to suicide attempt. In this context, the importance of awareness and knowledge by plastic surgeons is evident. The present study aimed to analyze if Brazilian plastic surgeons are aware of how important body dysmorphic disorder is in their practice; identify if Brazilian plastic surgeons investigate the presence of BDD in their patients prior to surgery, and verify the reasons why they do not; and to access how Brazilian plastic surgeons proceed when they suspect the presence of BDD. This is a cross-sectional, observational, prospective study with quantitative approach. It was applied a semi-structured online questionnaire on a sample of 6.078 plastic surgeons, after ethical and administrative approvals, as to provide an answer for the proposed goal. The main findings were a responders population constituted of 160 specialists, mainly male (63,7%) and young (70% being younger than 45 years old), and about half of the sample with less than 11 years of graduation and board-certification. Regarding the routine of asking for psychiatric evaluation, 23,7% of the plastic surgeons have said that they never do. As the awareness about BDD, only 9,4% of the participants have said to be familiar with the clinical characteristics of the disorder and 13,1% found themselves updated with diagnostic criteria, and 18,1% had no knowledge about them. It is observed that the investigation about image disorders is made invariably in only 18,8% of the cases and only 8,8% (14 individuals) are acquainted with any early diagnosis instruments of the disorder. Furthermore, even with 56,2% believing that BDD is an absolute contraindication for aesthetic surgery, and 57,5% assuming that they do not perform the surgery when they identify the presence of DBB, 80% of the sample have performed some kind of procedure on patients with the disorder, only lately suspecting the condition. In addition, about 41% of the doctors have suffered some kind of threat from these patients. Therefore, it was concluded that Brazilian plastic surgeons have limited awareness about the importance of BDD in their practice; that they rarely investigate the presence of this disorder in their patients before operating on them, mainly because of the lack of awareness to the clinical characteristics of the disorder and the lack of knowledge about screening instruments; and when faced with an eventual suspicion of BDD, these professionals tend not to treat or refer these patients to a specialized follow-up. On the other hand, 95% of the interviewed sample have interest in educational activities that can allow to overcome this disturbing reality
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spelling Martinez, José EduardoRibeiro, Fernanda Dias2019-09-30T11:46:05Z2019-09-12Ribeiro, Fernanda Dias. Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro. 2019. 78 f. Dissertação (Mestrado em Educação nas Profissões da Saúde) - Programa de Estudos Pós-Graduados em Educação nas Profissões da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, 2019.https://tede2.pucsp.br/handle/handle/22648Body dysmorphic disorder from Brazilian plastic surgeon’s optic. On a scenario where the reinless search for beauty ideals is observed, associated with the ascending panorama of plastic surgery, the body dysmorphic disorder (BDD) stands out as a psychiatric disorder of high prevalence between patients that seek for cosmetic treatments, frequently serious, underdiagnosed and underreported. The BDD is defined as an excessive preoccupation about a minimal or imperceptive flaw for other people. That excessive concern causes significative clinical suffering or social, occupational or any other important functioning area impairment. The BDD is also associated with poor quality of life, which may lead to high rates of suicidal ideation and even to suicide attempt. In this context, the importance of awareness and knowledge by plastic surgeons is evident. The present study aimed to analyze if Brazilian plastic surgeons are aware of how important body dysmorphic disorder is in their practice; identify if Brazilian plastic surgeons investigate the presence of BDD in their patients prior to surgery, and verify the reasons why they do not; and to access how Brazilian plastic surgeons proceed when they suspect the presence of BDD. This is a cross-sectional, observational, prospective study with quantitative approach. It was applied a semi-structured online questionnaire on a sample of 6.078 plastic surgeons, after ethical and administrative approvals, as to provide an answer for the proposed goal. The main findings were a responders population constituted of 160 specialists, mainly male (63,7%) and young (70% being younger than 45 years old), and about half of the sample with less than 11 years of graduation and board-certification. Regarding the routine of asking for psychiatric evaluation, 23,7% of the plastic surgeons have said that they never do. As the awareness about BDD, only 9,4% of the participants have said to be familiar with the clinical characteristics of the disorder and 13,1% found themselves updated with diagnostic criteria, and 18,1% had no knowledge about them. It is observed that the investigation about image disorders is made invariably in only 18,8% of the cases and only 8,8% (14 individuals) are acquainted with any early diagnosis instruments of the disorder. Furthermore, even with 56,2% believing that BDD is an absolute contraindication for aesthetic surgery, and 57,5% assuming that they do not perform the surgery when they identify the presence of DBB, 80% of the sample have performed some kind of procedure on patients with the disorder, only lately suspecting the condition. In addition, about 41% of the doctors have suffered some kind of threat from these patients. Therefore, it was concluded that Brazilian plastic surgeons have limited awareness about the importance of BDD in their practice; that they rarely investigate the presence of this disorder in their patients before operating on them, mainly because of the lack of awareness to the clinical characteristics of the disorder and the lack of knowledge about screening instruments; and when faced with an eventual suspicion of BDD, these professionals tend not to treat or refer these patients to a specialized follow-up. On the other hand, 95% of the interviewed sample have interest in educational activities that can allow to overcome this disturbing realityTranstorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro. Num cenário em que se observa busca desenfreada pelos ideais de beleza, aliado ao panorama ascendente em que se encontra a cirurgia plástica, destaca-se o transtorno dismórfico corporal (TDC), um distúrbio psiquiátrico de alta prevalência em pacientes que buscam tratamentos cosméticos, frequentemente grave, subdiagnosticado e subrelatado. É definido como uma preocupação excessiva com um defeito mínimo ou que não pode ser observável por outro e, essa preocupação deve causar sofrimento clinicamente significativo ou prejuízo social, ocupacional ou em alguma outra área importante de funcionamento. Associam-se ainda ao TDC, má qualidade de vida, podendo determinar altas taxas de ideação e tentativa de suicídio. Nesse contexto, evidencia-se a importância da conscientização e conhecimento desse transtorno pelos cirurgiões plásticos. O presente estudo objetivou analisar se o cirurgião plástico brasileiro tem consciência da importância do TDC em sua prática; identificar se os cirurgiões plásticos brasileiros pesquisam a presença do TDC no pré-operatório de seus pacientes e verificar as razões desta não pesquisa; e conhecer a conduta do cirurgião plástico brasileiro quando existe a suspeita do TDC. Trata-se de estudo transversal observacional, prospectivo, descritivo de abordagem quantitativa. Foi enviado questionário eletrônico semiestruturado numa amostra de cerca de 6078 cirurgiões plásticos, após as aprovações éticas e administrativas necessárias, para dar resposta ao objetivo proposto. Os principais achados foram uma população de respondedores constituída por 160 especialistas, predominantemente masculina (63,7%) e jovem (70% com idade até 45 anos), sendo aproximadamente a metade com tempo de formação e titulação como especialista há menos de 11 anos. Em relação ao hábito de solicitar avaliação psicológica, 23,7% dos cirurgiões afirmam nunca o fazer. Sobre a conscientização dos participantes sobre o TDC, somente 9,4% sentem-se familiarizados às suas características clínicas e 13,1% encontram-se atualizados aos critérios diagnósticos, sendo que 18,1% dos cirurgiões plásticos afirmam desconhecê-los. Notou-se que a investigação sobre distúrbios da imagem é realizada, invariavelmente, em apenas 18,8% dos casos e apenas 8,8% conhecem algum instrumento de diagnóstico precoce para o transtorno. Além disso, mesmo que 56,2% dos entrevistados acreditem que o TDC seja uma contraindicação absoluta para a cirurgia estética, e que 57,5% deles não realizem a cirurgia quando identificam esse distúrbio, 80% da amostra afirma já ter realizado algum procedimento nesses pacientes, suspeitando tardiamente desta condição. Além disso, cerca de 41% dos médicos já sofreram algum tipo de ameaça desses pacientes. Assim, concluiu-se que cirurgiões plásticos brasileiros têm limitada consciência da importância do TDC em sua prática; que raramente pesquisam esse distúrbio entre seus pacientes antes de operá-los, principalmente pela falta de conscientização/familiaridade às suas características clínicas e pelo desconhecimento de instrumentos específicos de triagem; e quando eventualmente suspeita do TDC, esses profissionais tendem a não tratar ou encaminhar esses pacientes para acompanhamento especializado. Por outro lado, há interesse em 95% dos entrevistados para atividades educativas que possam superar esta preocupante realidadeapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/50525/Fernanda%20Dias%20Ribeiro.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em Educação nas Profissões da SaúdePUC-SPBrasilFaculdade de Ciências Médicas e da SaúdeCirurgia plásticaTranstornos Dismórficos CorporaisImagem corporalSurgery, PlasticBody Dysmorphic DisordersBody imageCNPQ::CIENCIAS DA SAUDETranstorno dismórfico corporal sob a ótica do cirurgião plástico brasileiroinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTFernanda Dias Ribeiro.pdf.txtFernanda Dias Ribeiro.pdf.txtExtracted texttext/plain131305https://repositorio.pucsp.br/xmlui/bitstream/handle/22648/4/Fernanda%20Dias%20Ribeiro.pdf.txtbb5db5b51aef79b0bad7de29af4a5f91MD54LICENSElicense.txtlicense.txttext/plain; charset=utf-82165https://repositorio.pucsp.br/xmlui/bitstream/handle/22648/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51ORIGINALFernanda Dias Ribeiro.pdfFernanda Dias Ribeiro.pdfapplication/pdf2477465https://repositorio.pucsp.br/xmlui/bitstream/handle/22648/2/Fernanda%20Dias%20Ribeiro.pdff9b32b34369c468c4726df8ba3db9b1bMD52THUMBNAILFernanda Dias Ribeiro.pdf.jpgFernanda Dias Ribeiro.pdf.jpgGenerated Thumbnailimage/jpeg2185https://repositorio.pucsp.br/xmlui/bitstream/handle/22648/3/Fernanda%20Dias%20Ribeiro.pdf.jpg676751dea765155880b6a33f3b885fc2MD53handle/226482022-04-28 12:37:55.624oai:repositorio.pucsp.br: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Biblioteca Digital de Teses e Dissertaçõeshttps://sapientia.pucsp.br/https://sapientia.pucsp.br/oai/requestbngkatende@pucsp.br||rapassi@pucsp.bropendoar:2022-04-28T15:37:55Biblioteca Digital de Teses e Dissertações da PUC_SP - Pontifícia Universidade Católica de São Paulo (PUC-SP)false
dc.title.por.fl_str_mv Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
title Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
spellingShingle Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
Ribeiro, Fernanda Dias
Cirurgia plástica
Transtornos Dismórficos Corporais
Imagem corporal
Surgery, Plastic
Body Dysmorphic Disorders
Body image
CNPQ::CIENCIAS DA SAUDE
title_short Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
title_full Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
title_fullStr Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
title_full_unstemmed Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
title_sort Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro
author Ribeiro, Fernanda Dias
author_facet Ribeiro, Fernanda Dias
author_role author
dc.contributor.advisor1.fl_str_mv Martinez, José Eduardo
dc.contributor.author.fl_str_mv Ribeiro, Fernanda Dias
contributor_str_mv Martinez, José Eduardo
dc.subject.por.fl_str_mv Cirurgia plástica
Transtornos Dismórficos Corporais
Imagem corporal
topic Cirurgia plástica
Transtornos Dismórficos Corporais
Imagem corporal
Surgery, Plastic
Body Dysmorphic Disorders
Body image
CNPQ::CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Surgery, Plastic
Body Dysmorphic Disorders
Body image
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE
description Body dysmorphic disorder from Brazilian plastic surgeon’s optic. On a scenario where the reinless search for beauty ideals is observed, associated with the ascending panorama of plastic surgery, the body dysmorphic disorder (BDD) stands out as a psychiatric disorder of high prevalence between patients that seek for cosmetic treatments, frequently serious, underdiagnosed and underreported. The BDD is defined as an excessive preoccupation about a minimal or imperceptive flaw for other people. That excessive concern causes significative clinical suffering or social, occupational or any other important functioning area impairment. The BDD is also associated with poor quality of life, which may lead to high rates of suicidal ideation and even to suicide attempt. In this context, the importance of awareness and knowledge by plastic surgeons is evident. The present study aimed to analyze if Brazilian plastic surgeons are aware of how important body dysmorphic disorder is in their practice; identify if Brazilian plastic surgeons investigate the presence of BDD in their patients prior to surgery, and verify the reasons why they do not; and to access how Brazilian plastic surgeons proceed when they suspect the presence of BDD. This is a cross-sectional, observational, prospective study with quantitative approach. It was applied a semi-structured online questionnaire on a sample of 6.078 plastic surgeons, after ethical and administrative approvals, as to provide an answer for the proposed goal. The main findings were a responders population constituted of 160 specialists, mainly male (63,7%) and young (70% being younger than 45 years old), and about half of the sample with less than 11 years of graduation and board-certification. Regarding the routine of asking for psychiatric evaluation, 23,7% of the plastic surgeons have said that they never do. As the awareness about BDD, only 9,4% of the participants have said to be familiar with the clinical characteristics of the disorder and 13,1% found themselves updated with diagnostic criteria, and 18,1% had no knowledge about them. It is observed that the investigation about image disorders is made invariably in only 18,8% of the cases and only 8,8% (14 individuals) are acquainted with any early diagnosis instruments of the disorder. Furthermore, even with 56,2% believing that BDD is an absolute contraindication for aesthetic surgery, and 57,5% assuming that they do not perform the surgery when they identify the presence of DBB, 80% of the sample have performed some kind of procedure on patients with the disorder, only lately suspecting the condition. In addition, about 41% of the doctors have suffered some kind of threat from these patients. Therefore, it was concluded that Brazilian plastic surgeons have limited awareness about the importance of BDD in their practice; that they rarely investigate the presence of this disorder in their patients before operating on them, mainly because of the lack of awareness to the clinical characteristics of the disorder and the lack of knowledge about screening instruments; and when faced with an eventual suspicion of BDD, these professionals tend not to treat or refer these patients to a specialized follow-up. On the other hand, 95% of the interviewed sample have interest in educational activities that can allow to overcome this disturbing reality
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-09-30T11:46:05Z
dc.date.issued.fl_str_mv 2019-09-12
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dc.identifier.citation.fl_str_mv Ribeiro, Fernanda Dias. Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro. 2019. 78 f. Dissertação (Mestrado em Educação nas Profissões da Saúde) - Programa de Estudos Pós-Graduados em Educação nas Profissões da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, 2019.
dc.identifier.uri.fl_str_mv https://tede2.pucsp.br/handle/handle/22648
identifier_str_mv Ribeiro, Fernanda Dias. Transtorno dismórfico corporal sob a ótica do cirurgião plástico brasileiro. 2019. 78 f. Dissertação (Mestrado em Educação nas Profissões da Saúde) - Programa de Estudos Pós-Graduados em Educação nas Profissões da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, 2019.
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