Psychiatric disorders in cosmetic dermatology patients

On October 9, Dr. Le Thao Hien (Department of Dermatology, Ho Chi Minh City Dermatology Hospital) said that the more cosmetic interventions are performed, the more dissatisfaction of customers will increase. Due to the failures of the procedure, a large number of patients are always sad and self-conscious about their appearance, even though the defect is insignificant. At that time, even though effective cosmetic procedures have been performed, they will not realize this and lead to litigation.

Dissatisfaction with appearance and self-improvement through cosmetic procedures may be related to self-esteem, the desire for social approval, and the pursuit of beauty trends. Among these, three common psychiatric disorders in cosmetic patients are body dysmorphic disorder, narcissistic personality disorder, and histrionic personality disorder.

Body dysmorphic disorder

"Body dysmorphic disorder is a type of "body dysmorphic disorder" according to the Diagnostic and Statistical Manual of Mental Disorders. They are often preoccupied with an imaginary or excessive defect in appearance. This frequency in the general population is about 2-15%," Dr. Hien shared.

Accordingly, the patient often worries about small or non-existent defects. For example, describing themselves as “unattractive”, “deformed”, “hideous”, “like a monster”. They often feel fear of rejection and a sense of damaged self-esteem, shame, guilt, feeling useless and hateful. Their gaze is no longer bright. Paranoia when thinking that others are staring at and mocking their defects

Repetitive behaviors include mirror checking, comparison with others, grooming, disguise (such as wearing hats, clothes, makeup), dressing up, and dieting.

Impaired social functioning, few or no friends, avoidance of dating and other social interactions, impaired academic and occupational functioning.

Rối loạn tâm thần ở bệnh nhân thẩm mỹ da - Ảnh 1. — Doctor Le Thao Hien consults a patient coming for a skin examination

Narcissistic personality disorder

Dr. Hien said that narcissistic personality disorder is a type of mental disorder found in 25% of cosmetic skin patients. Of these, 15-20% are male. Narcissistic personality disorder appears in adolescence or early adulthood.

"Patients often have problems with self-identity, unclear self-perception, inconsistency in values, goals, and appearance. Self-centeredness, exaggerated self-perception, lack of empathy for others, and being driven by self-esteem," Dr. Hien analyzed.

They are often preoccupied with fantasies of great achievement because of their intelligence or beauty, of prestige and influence. They feel they should only associate with special and talented people.

However, they often do not realize they have a problem, causing confusion and frustration to those around them (including clinicians).

Histrionic personality disorder

"This disorder is characterized by excessive attention seeking and a common pattern of exaggerated emotional expression, including a desire for acceptance and inappropriate seductive behavior. This type of mental disorder accounts for 2-3% of the population and 9.7% of cosmetic surgery patients," said Dr. Hien.

Recognizing a person with histrionic personality disorder can be difficult because they are often highly intelligent, do well in school and work. They often have unrealistic expectations when it comes to themselves and the results of cosmetic procedures, and are never satisfied with the results of treatment.

"Detecting and identifying mental disorders in cosmetic skin patients helps doctors decide whether the patient wants to undergo the procedure, refuses to undergo it, or transfers to the Psychiatry department," Dr. Hien shared.

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