| Objective:Body deformation disorder(BDD)is a common psychological disease in plastic surgery department,in order to better understand the prevalence of BDD in plastic surgery population and improve the understanding of the disease among plastic surgery practitioners.It is urgent to optimize BDD-YBOCS scale and test its reliability and validity.Through epidemiological investigation and prevalence statistics of plastic surgery patients,the incidence and possible related factors of BDD in plastic surgery patients were further clarified.In addition,the safety and clinical efficacy of transcutaneous acupoint electrical stimulation in patients with BDD were evaluated,which is expected to provide a new treatment method and theoretical basis for the treatment of BDD patients.Methods:The cross-sectional studies on the prevalence of BDD in cosmetic surgery population published at home and abroad were retrieved and synthesized by meta-analysis.The heterogeneity among the studies was analyzed by Cochrane Q test,the source of heterogeneity was judged by subgroup analysis and sensitivity analysis was conducted,and the publication bias was judged by funnel plot.In order to obtain the prevalence of BDD in plastic surgery population.The BDD-YBOCS scale was translated and adjusted according to Brislin’s two person literal and back translation principle.A total of 240 patients were included in the study from May 2020 to September 2020.Take cronbcah’s as an example α Coefficient and test-retest reliability coefficient reflect the reliability of the questionnaire.Exploratory factor analysis was used to analyze the construct validity.Spearman correlation coefficient was used to analyze the correlation between BDD-YBOCS and BDDQ(criterion validity),and the correlation between BDD-YBOCS and BDDQ(sensitivity).The validated Chinese version of BDD-YBOCS was applied to patients who cam e to our plastic surgery department for consultation or surgery from May 2020 to February 2021.After obtaining the consent,the scale was issued and the questionnaire was collected.SPSS 22.0 was used for data processing,and the logistic binary regression model was used to analyze each factor one by one.Finally,60 plastic surgery patients with BDD positive were randomly divided into experimental group(operation combined with electrical stimulation group)and control group(operation without stimulation group).χ 2 test or one-way ANOVA were used for data processing.Objective to analyze the effect of transcutaneous electrical acupoint stimulation at Baihui,Neiguan(Shuang)and Yintang on BDD plastic surgery patients during perioperative period.Results:Th e final 13 articles were included in the meta-analysis,there was a high degree of heterogeneity,using the random effect model,the results showed that the prevalence of BDD was 13%(95%CI:9-18%).The results of sensitivity analysis are stable and reliable.The results showed that the prevalence rate of rhinoplasty group was 29%(95%CI:24-35%),and that of other parts of plastic surgery group was 9%(8-10%).Funnel plot showed no publication bias.No items were removed from the original English version of the BDD-YBOCS based on expert interviews and factor analysis.220 patients completed the study survey(91.7%).EFA extracted 3 factors,which accounted for 64.50%of the variance.CFA supported a 3-factor structure(χ2/df=1.322,RMSEA=0.054,GFI=0.904,NFI=0.902,CFI=0.974 and TLI=0.966).The scale had good covergent and discriminant validity.Cronbach’s α for the scale was 0.871(P<0.001),and ranged from 0.852 to 0.873 when individual items were removed.We found that the prevalence of BDD was 14%(539/3838)(BDD-YBOCS total score≥20).The age,education level,history of plastic surgery,repair patients and the type of consultation surgery are related to the occurrence of BDD,which can be considered as risk factors.For mild to moderate BDD patients,cosmetic surgery can significantly alleviate the symptoms of BDD.The effective rates were 83.3%and 66.7%,respectively.But there was no significant difference between the two groups.In addition,we found that in combination with transcutaneous acupoint electrical stimulation group,patients’ self-evaluation of curative effect was better than that of the third-party evaluation of curative effect.It is speculated that the treatment of emotional relaxation and pleasure in the process of transcutaneous electrical acupoint stimulation can significantly relieve the patients’ anxiety and other adverse mood during the perioperative period,which is of great help to improve the satisfaction of surgery.Conclusion:Through meta-analysis,we found that the incidence of BDD is very high in cosmetic surgery group,especially in rhinoplasty patients.Remind doctors to pay attention to the psychological state of plastic surgery crowd.The Chinese version of BDD-YBOCS has good reliability and validity,and can be widely used in the screening of BDD,the judgment of severity level and the quantitative index of therapeutic effect in cosmetic surgery population.Using this tool,we found that the prevalence of BDD was about 14%.Our study findings suggest that more younger patients with a lower education level experience BDD when compared to their older counterparts.Those patients who had a history of plastic surgery,sought a reoperation,or consulted with a plastic/cosmetic surgeon about procedures to improve their breasts,nose,or body shape were at higher risk for BDD.For mild to moderate BDD patients,cosmetic surgery can improve the severity of BDD.Transcutaneous acupoint electrical stimulation can improve the perioperative bad mood of plastic surgery patients,so as to improve the surgical satisfaction. |
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