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Body Image Concern Inventory (BICI) for Identifying Patients with BDD Seeking Rhinoplasty: Using a Persian (Farsi) Version

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Abstract

Background

Dissatisfaction with appearance is most pronounced in rhinoplasty patients compared to candidates for other aesthetic procedures. We aimed to test and introduce the Body Image Concern Inventory (BICI) as a self-report screening tool for identifying body dysmorphic disorder (BDD) among patients seeking rhinoplasty.

Methods

The surgeon completed a two-point defect severity scale in which a score of 1 represented no defect or one defect and a score of 2 represented more than one defect. Each of the 117 subjects with a score of 1 answered a questionnaire that was designed to obtain demographic data and completed the Persian version of the BICI. The psychiatrist, considering the patient’s demographic data and blind to the BICI score, interviewed him/her using a semistructured diagnostic tool for BDD based on DSM-IV.

Results

The validity of the Persian version of the BICI was calculated at 85%. The reliability of the Persian BICI items was tested and Cronbach’s alpha was 0.90. The results of ROC analysis for the ideal cutoff point of the Persian BICI, based on the Youden index method and optimum sensitivity and specificity, revealed that the ideal cutoff point for positive or negative criterion of that questionnaire’s result may be the total score of 42 (sensitivity, 93.5%; specificity, 80.8%) The diagnostic accuracy of the Persian BICI in comparison with the gold standard (psychiatric interview), according to the area under the ROC curve (AUC), was 91.4% (95% CI = 86–97%, P < 0.0001). The agreement of the results of the Persian BICI questionnaire with the psychiatric interview for diagnosis of BDD, according to kappa index, was 61.7% (P < 0.001), and the odds ratio (OR) of being diagnosed with BDD in a psychiatric interview for those with overall scores ≥42 for the Persian BICI was 47.7 (95% CI = 43–52).

Conclusion

The results of the present study emphasize the high rate of BDD (12.2%) in subjects seeking rhinoplasty. The BICI appears to be an internally consistent and valid brief multiple-choice instrument for assessing dysmorphic concern. To our knowledge, this is the first time that this measure has ever been used for identifying BDD patients in a rhinoplasty setting; it is also the first time that ROC analysis has been used for calculating and analyzing the results of BICI. Our study suggests that rhinoplasty surgeons could rely on the scores of the BICI to identify subjects with probable BDD among their consultants with no or one slight defect.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran

    Saber Ghadakzadeh & Negar Karimian

  2. 736 Bay Street, Unit # 2908, Toronto, ON, M5G 2M4, Canada

    Saber Ghadakzadeh

  3. Department of ENT, Imam Educational Hospital, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran

    Ali Ghazipour

  4. Department of Psychiatry, Golestan Educational Hospital, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran

    Niloufar Khajeddin

  5. Department of Statistics and Epidemiology, Faculty of Medicine, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran

    Mehrdad Borhani

Authors
  1. Saber Ghadakzadeh
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  2. Ali Ghazipour
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  3. Niloufar Khajeddin
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  4. Negar Karimian
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  5. Mehrdad Borhani
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Correspondence to Saber Ghadakzadeh.

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Ghadakzadeh, S., Ghazipour, A., Khajeddin, N. et al. Body Image Concern Inventory (BICI) for Identifying Patients with BDD Seeking Rhinoplasty: Using a Persian (Farsi) Version. Aesth Plast Surg 35, 989–994 (2011). https://doi.org/10.1007/s00266-011-9718-8

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  • DOI: https://doi.org/10.1007/s00266-011-9718-8

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