Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden

Wesley H. Stepp; Eva J. Stein; Michael W. Canfarotta; Jeyhan Wood; Eva Vandoros; Margot Stein; Renie Daniel; William W. Shockley; Joseph Madison Clark; Amelia F. Drake

doi:10.1002/lary.30378

journal article Sep 02, 2022

Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden

Wesley H. Stepp

Eva J. Stein Michael W. Canfarotta

Jeyhan Wood Eva Vandoros Margot Stein Renie Daniel William W. Shockley Joseph Madison Clark Amelia F. Drake

The Laryngoscope Vol. 133 No. 4 pp. 818-821 · Wiley

View at Publisher Save 10.1002/lary.30378

Abstract

ObjectivesFacial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and/or palate (CL/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL/P and characterizes the degree of FDD symptoms in an adult craniofacial population.MethodsThis was a prospective, single‐center, cross‐sectional case–control study using semi‐structured interviews and symptom assessments at a university‐based craniofacial center. Patients without CL/P undergoing non‐cosmetic facial surgery were recruited as controls (n = 20). Patients with an orofacial cleft (n = 30) were recruited from medical and dental providers at the University of North Carolina. Body Dysmorphic Disorder‐Yale Brown Obsessive Compulsive Scale (BBD‐YBOCS) scores were collected from a control population and patients with CL/P to assess FDD severity.ResultsDemographic factors such age, biological sex, and ethnicity had no significant impact on FDD symptom scores. Patient with CL/P were more likely to have significant FDD symptoms (BDD‐YBOCS greater than 16) than patients without CL/P (OR 10.5, CI95 2.7–41.1), and had a mean difference in FDD symptoms scores of 10.04 (p < 0.0001; CI95 5.5–14.6). Patients with CL/P seen by a mental health provider in the past 3 months had 3‐fold lower overall FDD symptom scores (OR 0.081; CI95 0.0085–0.77).ConclusionsAdults with CL/P would benefit from treatment for cleft‐specific needs and psychological support as they face unique stressors related to their appearance, including an increase in FDD‐associated symptoms. This study emphasizes the importance of recognizing psychological symptoms and providing ongoing multidisciplinary care to adults with CL/P.Level of Evidence3; Individual case–control study Laryngoscope, 133:818–821, 2023

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Citations

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Details

Published: Sep 02, 2022
Vol/Issue: 133(4)
Pages: 818-821
License: View

Authors

W

Wesley H. Stepp

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

E

Eva J. Stein

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

M

Michael W. Canfarotta

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

J

Jeyhan Wood

University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry Chapel Hill North Carolina U.S.A.; Department of Surgery University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

E

Eva Vandoros

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

M

Margot Stein

University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry Chapel Hill North Carolina U.S.A.

R

Renie Daniel

University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry Chapel Hill North Carolina U.S.A.; Department of Oral and Maxillofacial Surgery University of North Carolina, School of Dentistry Chapel Hill North Carolina U.S.A.

W

William W. Shockley

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

J

Joseph Madison Clark

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.

A

Amelia F. Drake

Department of Otolaryngology University of North Carolina, School of Medicine Chapel Hill North Carolina U.S.A.; University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry Chapel Hill North Carolina U.S.A.

Funding

National Institute of General Medical Sciences Award: NIHT32‐GM008719

National Institute of Dental and Craniofacial Research Award: 5T32DC005360

Alpha Omega Alpha Honor Medical Society

Wisconsin Historical Society

Cite This Article

Wesley H. Stepp, Eva J. Stein, Michael W. Canfarotta, et al. (2022). Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden. The Laryngoscope, 133(4), 818-821. https://doi.org/10.1002/lary.30378

Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden

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