Introduction
Psychiatric comorbidity refers to additional psychological conditions that require separate attention during a clinical diagnosis. Apart from the general medical diagnosis, patients need to undergo psychiatric diagnoses to determine whether a patient has got any depression or panic disorder resulting from the physical condition they are suffering from. Modern medicine requires patients to undergo psychiatric diagnoses because cases of psychiatric comorbidity are reported to be on the increase. Comorbidity cases are taken as distinct clinical entities that require multiple psychiatric diagnoses. Medical practitioners are bound to encounter psychiatric comorbidity cases regardless of their areas of specialization (Walker 35). Psychiatric comorbidity is normally classified as a distinct diagnostic category that a doctor in charge of a patient deals with or can later be referred to a psychiatrist for optimal care. Psychiatric comorbidity conditions have a great impact on the medical treatment of a patient depending on how the situation is handled. This paper will highlight some of the comorbidity conditions associated with cosmetic surgery patients.
Body Dysmorphic Disorder is a psychiatric comorbidity condition associated with cosmetic surgery patients (Veale 16). The disease is in most cases underrecognized despite its severity. Among the many psychiatric illnesses available, Body Dysmorphic Disorder cases receive less attention or are never reported at all (Hollander 22). Body Dysmorphic Disorder is a psychotic disorder that is triggered by obsession and compulsion (Walker 35). Patients suffering from this condition are always dissatisfied with their physical appearance with any form of physical anomaly causing them a lot of anxiety. Some of the defects that BDD patients claim to have are imaginary and cause them unnecessary concern. The patients are always preoccupied with the appearance of their face, ears, and hair (Phillips 24). In addition to the facial features, patients are also concerned about their sexual features such penis size for men and breasts for women.
Main body
The entire body of a patient suffering this type of comorbidity condition is always under focus and any kind of anomaly however small causes them a lot of distress. The effects of Body Dysmorphic Disorder on a patient’s life are very severe and cannot be underestimated in any way (Walker 56). The social and occupational life of a patient suffering from this condition is completely halted in addition to the distress the condition brings. Some patients completely stop going out or socializing because they feel that their looks are very unattractive (Walker 56). Medical statistics reveal that women are the most affected by this comorbidity condition compared to men.
The psychosocial functioning of patients suffering from Body Dysmorphic Disorder is normally poor and in the long run, affects the quality of their life. Body Dysmorphic Disorder is associated with high rates of hospitalization compared to other comorbidity conditions (Hollander 69). Many-Body Dysmorphic Disorder patients are reported to die from suicide with a significant number of suicide attempts being reported. Cosmetic surgery patients are the most affected by Body Dysmorphic Disorder compared to other types of surgery. A large percentage of persons who undergo cosmetic surgery are never satisfied with results and will always shift attention to another body part after another has been operated on (Hollander 69). The patients are always anxious about the outcome of cosmetic surgery and failure to meet their expectations spells doom for cosmetic surgeons. Some patients are reported to be violent to an extent of even murdering the surgeon responsible for their surgery (Boyd 92). The post-operative site is what aggravates the Body Dysmorphic Disorder.
Body Dysmorphic Disorder can develop into a chronic condition if it is not treated in time (Phillips 85). This type of comorbidity condition is said to be common during the early adolescent stage when young boys and girls are always obsessed with their physical appearance. There is still an argument on whether (BDD) is hereditary or not. Some studies show that genetic factors are among the causes of BDD. Some of the symptoms of BDD include sadness, shame, low self-esteem, and anxiety (Phillips 85). Individuals suffering from this condition find it difficult to point out anything positive about themselves with their views about physical attractiveness being very disproportionate. A person suffering from this condition spends a lot of time in front of their mirrors looking for ways of covering up their defects. The BDD patients are always uncomfortable around people and always seek reassurance from friends and experts about their physical appearance (Phillips 84). Modern society has placed much emphasis on beauty and this makes many people feel inadequate about their looks. Physicians find it difficult to diagnose BDD because many patients are always reluctant to talk about their situation.
Healthcare professionals are trained to treat comorbidity conditions such as BDD with complicated cases being referred to a psychiatrist (Veale 115). It is important to treat BDD because it can impact the medical treatment of a patient. In the case of cosmetic surgery, the desired results may not be achieved because the expectations of a patient with this sort of condition are always unrealistic (Veale 116). The psychological state of a patient determines whether the patient is likely to respond positively to treatment or not. The negative mindset of a patient suffering from BDD affects their healing process. It is therefore advisable to treat the BDD before a patient undergoes cosmetic surgery and follow it up with post-surgery therapy to ensure the patient is completely healed (Veale 170).
There are quite a several treatments available for BDD depending on how serious the condition is. Cognitive behavior therapy is a special kind of therapy performed on adolescents and adults suffering from BDD (Walker 42). Cognitive behavior therapy treats both the behavioral and psychological aspects of BDD. Behavior therapy combined with psychotherapy helps a BDD patient to challenge all the negative feelings manifested in their attitudes and thoughts (Walker 215). The cognitive processes of the mind are challenged by this kind of therapy to try and erase all the negativity associated with BDD. Cognitive behavior therapy helps a person develop a new mindset that can withstand and cope with difficult emotional situations. Through cognitive behavior therapy, a patient can do away with negative forms of behavior and at the same time improve their emotional wellbeing (Walker 215). This form of therapy should be administered consistently until the patient completely stops engaging in self-destructive behavior.
Cognitive behavior therapy focuses on changing the attitudes of patients towards their physical appearance and perceived defects (Walker 215). In the course of this therapy, the psychiatrist tries to shift the attention of patients from their physical appearance to other things. By doing this, a patient stops comparing their appearance with that of their peers and at the same time forget about their perceived defects. This therapy also stops rituals such as excessive grooming and spending a lot of time in front of the mirror. Cognitive behavior therapy may be hampered by initial anxiety but the fear tends to disappear with time (Weziroglu 78). Cognitive behavior therapy includes behavioral experiments, behavior response prevention for compulsive behavior, social exposure to prevent avoidance, and cognitive restructuring for patients to develop a positive attitude towards their appearance (Weziroglu 78). Cognitive behavior therapy can be carried out on a single patient or in a group session.
Antidepressant medication is another form of treatment given to BDD patients. Serotonin-Specific Reuptake inhibitors (SSRI) is a type of antidepressant commonly used to treat BDD (Hollander 122). The main function of SSRIs is to prolong the action of serotonin by blocking its reuptake from the brain. Serotonin is a chemical produced by the nerve cells in the human brain and is known to reduce stress and depression (Hollander 123). SSRI drugs are taken daily for around three months to test their effectiveness. The treatment is later continued for one year if it is to be proved effective during the first 12 weeks. To minimize withdrawal symptoms, it is advisable to stop taking SSRIs gradually.
Cognitive behavior therapy and SSRIs are the most preferred forms of treatment for a patient with BDD. In a case where these two treatments fail, the next course of action is to try another brand of SSRI or prescribe the clomipramine antidepressant (Hollander 123). Optimal care is essential for a BDD patient to recover completely. Referral to a psychiatrist is important because some psychological conditions associated with BDD may prove to be difficult for a cosmetic surgeon. BDD patients require full support from their family and friends to completely recover from their condition (Boyd 498). Psychiatrists use psychotherapy and counseling sessions. There are volunteer organizations that offer counseling services for willing BDD patients. Specialist clinics for BDD take care of BDD cases that are beyond primary treatment. Some of the reasons why BDD treatment may fail to work include taking a low dose, a shorter medication period, and medication side effects. Cognitive behavior therapy is normally carried out by psychiatrists after a physician’s prescription fails (Boyd 498). Psychiatrists can follow up on the progress of patients after treatment to assess their progress. It takes a concerted effort by both physicians and psychiatrists in treating BDD.
Conclusion
In conclusion, Body Dysmorphic Disorder is a serious comorbidity condition that needs to be given some special attention. Although some progress has been made in training healthcare providers on how to handle and deal with comorbidity conditions such as BDD, the number of referrals to psychiatrists is still very high. The number of BDD cases that go unreported is high and this should be a cause for concern in the entire medical fraternity. Many physicians focus on treating diseases without giving any attention to the psychological condition of their patients. BDD will continue being a serious comorbidity condition if new modalities of treatment are not developed. The limited information about BDD is attributed to limited research in the area. Follow-up treatment should be a must for patients suffering from BDD because of the high number of suicide cases associated with BDD patients. Another point to note is that cosmetic surgery is not always the solution for patients suffering from BDD. Cosmetic surgery should be the last option after Cognitive behavior therapy and other forms of treatments have failed since some of the appearance defects are imaginary.
Works Cited
Boyd, Mary. Psychiatric Nursing: Contemporary Practice. New York: Lappincott Williams & Wilkins, 2207. Print.
Hollander, Erick. Obsessive-Compulsive Related Disorders. New York: American Psychiatric Publications, 1993. Print.
Phillips, Katherine. Understanding Body Dysmorphic Disorder. London: Oxford University Press, 2009. Print.
Veale, David. Body Dysmorphic Disorder: A Treatment Manual. New York: John Wiley & Sons, 2010. Print.
Walker, Pamela. Everything you need to Know about Treating Body Dysmorphic Disorder. New York: The Rosen Publishing Group, 1999. Print.
Weziroglu, Fugen. Overcoming Body Dysmorphic Disorder: A Cognitive Behavioral Approach to Reclaiming your Life. New York: New Harbinger Publications, 2012. Print.