Support system for decision making in the identification of risk for body dysmorphic disorder: a fuzzy model

Int J Med Inform. 2013 Sep;82(9):844-53. doi: 10.1016/j.ijmedinf.2013.04.007. Epub 2013 May 29.

Abstract

Purpose: To develop a fuzzy linguistic model to quantify the level of distress of patients seeking cosmetic surgery. Body dysmorphic disorder (BDD) is a mental condition related to body image relatively common among cosmetic surgery patients; it is difficult to diagnose and is a significant cause of morbidity and mortality. Fuzzy cognitive maps are an efficient tool based on human knowledge and experience that can handle uncertainty in identifying or grading BDD symptoms and the degree of body image dissatisfaction. Individuals who seek cosmetic procedures suffer from some degree of dissatisfaction with appearance.

Methods: A fuzzy model was developed to measure distress levels in cosmetic surgery patients based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criterion B for BDD. We studied 288 patients of both sexes seeking abdominoplasty, rhinoplasty, or rhytidoplasty in a university hospital.

Results: Patient distress ranged from "none" to "severe" (range=7.5-31.6; cutoff point=18; area under the ROC curve=0.923). There was a significant agreement between the fuzzy model and DSM-IV criterion B (kappa=0.805; p<0.001).

Conclusion: The fuzzy model measured distress levels with good accuracy, indicating that it can be used as a screening tool in cosmetic surgery and psychiatric practice.

Keywords: Body dysmorphic disorders; Fuzzy logic; Investigative techniques; Plastic surgery; Psychiatry; Somatoform disorders.

MeSH terms

  • Abdominoplasty / adverse effects*
  • Adult
  • Body Dysmorphic Disorders / diagnosis
  • Body Dysmorphic Disorders / etiology*
  • Body Dysmorphic Disorders / psychology*
  • Body Image*
  • Decision Making*
  • Female
  • Fuzzy Logic
  • Humans
  • Male
  • Models, Statistical
  • Rhinoplasty / adverse effects*
  • Rhytidoplasty / adverse effects*
  • Surgery, Plastic*
  • Surveys and Questionnaires