Body Image Disturbance and OCD Symptoms Improve after Orthognathic Surgery

Abstract Purpose Although body image disturbance (BID), anxiety, depression, and obsessive-compulsive disorder (OCD) are the most common comorbid psychological conditions among orthognathic surgery (OS) patients, little is known about whether psychological symptoms relate to facial deformity or how symptoms change after OS. To fill these knowledge gaps, this study investigated pre- and postoperative psychological symptoms and preoperative baseline facial deformity in OS patients. Methods This study included 49 patients who underwent OS by a single surgeon between 2011 and 2018. The patients completed validated psychological tests to assess symptoms of anxiety (Beck Anxiety Inventory), depression (Patient Health Questionnaire-9), BID (BID Questionnaire, BIDQ), and OCD (Florida Obsessive Compulsive Inventory, FOCI). In addition, we measured severity of preoperative facial deformity with the Facial Aesthetic Index. We compared pre- and postoperative symptoms using univariate nonparametric Wilcoxon signed-rank tests. We tested associations between the four types of preoperative psychological symptoms and baseline facial aesthetic index category using Spearman’s rank correlations. Results Postoperatively, both BIDQ scores (median 2 to 1.2, p 0.45). Preoperative BIDQ was significantly associated with the severity of the facial deformity (rho=0.32, p=0.025; median BIDQ: mild FAI=1.0, severe FAI=2.1). Conclusion Our results show that patients with more severe facial deformity have more extreme BID preoperatively and that both BID and OCD improve after OS. Interestingly, anxiety and depression symptoms were unchanged after OS.