Psychological aspects of a cosmetic procedure

Veale, David

doi:10.1383/psyt.2006.5.3.93

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Volume 5, Issue 3 , Pages 93-95, 1 March 2006

Psychological aspects of a cosmetic procedure

David Veale is a Consultant Psychiatrist in Cognitive Behaviour Therapy at the South London and Maudsley Trust and the Priory Hospital, North London, UK. He runs a national service in body dysmorphic disorder (BDD) and obsessive–compulsive disorder (OCD). He is an Honorary Senior Lecturer at the Institute of Psychiatry, King's College London, and was on the committee that produced the NICE guidelines on the treatment of OCD and BDD.

Abstract

This article discusses the psychiatric assessment of patients referred for a cosmetic procedure. Putative factors associated with poor outcome include being male; young; suffering from psychosis, severe depression or mania, an eating disorder, body dysmorphic disorder or significant personality disorder; having a ‘type-change’ procedure (e.g. rhinoplasty) rather than ‘restorative’ procedure (e.g. rhytidectomy); experiencing significant interference in their social and occupational functioning; having unrealistic expectations of outcome (for example, believing that they will obtain a new partner or job); or being dissatisfied by multiple areas of their body.

It should be emphasized that a single factor by itself is unlikely to be relevant and that there have been no prospective studies to evaluate the putative factors properly. The article focuses on body dysmorphic disorder and some suggestions are provided on engagement in therapy.

Keywords: psychological medicine , body dysmorphic disorder , cognitive–behavioural therapy , cosmetic procedures , engagement selective serotonin reuptake inhibitors

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