A Clinician’s Insight: Detecting Body Dysmorphic Disorder in Adnexal Patients
Author: Hae Seung Chung
Base Hospital / Institution: Barts and the London School of Medicine and Dentistry
ePoster presentation
Abstract ID: 25-428
Purpose
Body Dysmorphic Disorder (BDD) is characterised by excessive concern over minor or non-existent appearance flaws. Although validated screening tools like the Body Dysmorphic Disorder Questionnaire (BDDQ) exist, they are not routinely used in oculoplastic clinics. This study assessed the prevalence of BDD in an adnexal clinic and whether clinician judgement could reliably screen for BDD.
Methods
A prospective cross-sectional study was conducted at Moorfields Eye Hospital between June and December 2024. English-speaking patients were recruited. Participants completed a modified BDDQ-Dermatology Version (BDDQ-DV), including demographics, presenting complaints, and the impact of appearance concerns on daily life. Clinicians independently assessed the likelihood of BDD and rated their confidence.
Results
A total of 195 patients were recruited, with an average age of 64, mostly between 50 and 75. Those with moderate or severe distress on the BDDQ were classified as positive, resulting in a 37.3% positive screening rate, substantially higher than the UK average. No significant associations were found between BDD and age or gender. Clinician diagnostic accuracy compared to the BDDQ showed sensitivity of 85.9%, specificity of 88.8%, positive predictive value of 91%, and substantial agreement (Cohen’s Kappa = 0.74).
Conclusion
BDD may be under-recognised among adnexal clinic patients, highlighting the importance of routine psychological screening in this population. Our findings show that clinician insight can be a valuable method for identifying potential cases, particularly when formal screening tools are unavailable. However, as the BDDQ was developed in aesthetic contexts, it may capture appropriate concerns as BDD, inflating prevalence. These results emphasise the need for a holistic approach to patient care, addressing both psychological and physical impacts. Future studies should aim to validate clinician assessments with structured psychiatric evaluations and explore whether early psychological support improves long-term patient outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Gabriella | Guevera | Moorfields Eye Hospital |
| Swan | Kang | Moorfields Eye Hospital |
