مقایسه نمرات افسردگی بین بیماران جراحی بینی فانکشنال و زیبایی

Depression is a mood state of sadness, gloom, and pessimistic ideation with loss of interest or pleasure in normal activities. This mood disorder has been reported to occur more frequently among cosmetic surgery patients. The purpose of the current study was to compare the score of depression among aesthetic rhinoplasty candidates and functional rhinoplasty patients as control group. The Beck Depression Inventory (BDI) and Depression (DE) subscale of Symptom Check List-90-Revised (SCL-90-R) were administered on a sample of aesthetic rhinoplasty patients (n = 21) as well as a sample of functional rhinoplasty patients (n = 21). Those with both cosmetic and functional purposes were categorized regarding their primary objective. Questionnaires were given to patients preoperatively. Cohen's d was also calculated as a measure of Effect Size (ES). BDI and SCL-90-R-DE scores were analyzed using t-test for independent groups. Statistical analyses suggested that the mean BDI and SCL-90-R-DE scores of aesthetic surgery patients were significantly higher than those of functional surgery patients (P < 0.05). The results showed that age, sex, and Socio-Economic Status (SES) were not significantly different between the two groups as they can be capable of influencing the depression score. Effect size was above the moderate level: d = 0.51, d = 0.72 for BDI and SCL-90-R-DE, respectively. Using two different depression instruments, the findings of this study showed that aesthetic rhinoplasty patients were more depressed in comparison with functional rhinoplasty patients. The measures of ES also supported the hypothesis that aesthetic rhinoplasty candidates had higher scores in depression.

Aesthetic rhinoplasty refers to a type of plastic surgery, which is performed on the nose for aesthetic purposes. On the other hand, functional rhinoplasty is a surgical procedure in order for reconstruction or overcoming a functional nasal disorder. Aesthetic rhinoplasty is one of the most common cosmetic operations worldwide. Moreover, it has gained momentum in the past 2 decades considering the advances in this medical field and the increase in ideal images projected in the media (Haiken, 1997). Ideal images from mainstream media, increased popularity of cosmetic procedures, the emphasis on bodily appearance, and psychological motivations have had a role in the current increase in aesthetic rhinoplasty (Barahmand et al., 2010). It has been suggested that psychological aspects of aesthetic surgeries have a central role clinically (Wildgoose et al., 2013). Remarkably little is known about either the psychological status of persons who seek cosmetic surgery or potential psychological changes that may occur after surgery. Most people seeking cosmetic surgery procedures appear to be psychologically healthy; however some are not and for these individuals cosmetic procedures may have a negative outcome, creating problems for both patient and surgeon (Sarwer, 1997). Preoperative psychological distress in the form of anxiety and depression tends to be more common than physical complications in aesthetic surgery patients and more common in those with preoperative psychological symptoms (Borah et al., 1999). Some psychopathological characteristics have been studied within cosmetic surgery seekers. Body Dysmorphic Disorder (BDD) is recognized to be one of the most prevalent disorders within this population (Veale et al., 1996). Some studies have found evidence that preoccupation with the nose is the most common complaint in BDD, making cosmetic rhinoplasty the most common surgical correction sought by patients with BDD (Andretto Amodeo, 2007 and Crerand et al., 2005). Meyer et al. (1960) found that 16 out of 30 patients who sought rhinoplasty had psychological problems. In a more recent study (Piromchai et al., 2011), rhinoplasty candidates had higher scores of anxiety, insomnia, social dysfunction, depression, and somatic symptoms. Various studies indicate that body image of aesthetic rhinoplasty candidates are significantly lower than those of control group (Mowlawi et al., 2000 and Khajeddin and Izadi Mazidi, 2013). In this respect, recognition of patients with psychological problems, which may result in an unfavourable post-operative outcome, is essential (Honigman et al., 2004). Problems encountered by patients can lead to requests for repeated procedures, depression, adjustment problems, social isolation, familial dysfunction, self-destructive behaviours, and anger towards the surgeon (Goin and Rees, 1991). The purpose of the present study was to compare the depression scores between aesthetic rhinoplasty candidates and functional rhinoplasty patients using two distinct instruments. It was hypothesized that aesthetic rhinoplasty patients had higher scores of depression in comparison with functional rhinoplasty patients as the control group.

Twenty-one patients seeking aesthetic rhinoplasty and 21 patients seeking functional rhinoplasty participated in this study. Mean age in functional rhinoplasty group was 27.48 (SD = 10.40) and that of aesthetic rhinoplasty group was 25.57 (SD = 7.06). No significant difference was observed between means (P > 0.05). Demographic information of patients is summarized in Table 1. Table 1. Demographics. Aesthetic rhinoplasty patients Functional rhinoplasty patients N (%) 21 (50%) 21 (50%) Mean age 25.57 27.48 Gender Male 5 9 Female 16 12 Marital status Single 11 14 Married 9 6 Separated 1 1 Educational level Low 9 8 Medium 11 12 High 1 1 Socio-economic status Low 2 3 Medium 15 15 High 4 3 Table options Using t-test for independent groups, the analysis of the data demonstrated that the mean BDI and SCL-90-R scores in aesthetic surgery group were significantly higher than that of the functional surgery group (P < 0.05). Age, sex, Socio-Economic Status (SES), and educational backgrounds were analyzed and no significant relationship was found between the two groups (P > 0.05). Moreover, the Levene's test for equality of variances was not significant (P > 0.05). Independent t-test details for two utilized instruments are presented in Table 2. Table 2. Independent t-test details between aesthetic and functional groups. Instrument Number of items Cronbach's alpha Group Mean S.D. t-Test statistic One-tailed P-value Cohen's d BDI 21 0.91 Aesthetic 6.81 5.28 1.704 P < 0.05 0.51 Functional 3.95 5.58 SCL-90-R-DE 13 0.87 Aesthetic 11.71 8.49 2.496 P < 0.01 0.72 Functional 6.14 5.70