Introduction. - All plastic surgeons are frequently faced with patients with Body Dysmorphic Disorder (BDD). However, no screening test exists in French to help the plastic surgeons to diagnose this disease. The Body Dysmorphic Disorder Questionnaire (BDDQ) is the Gold Standard to easily detect BDD in consultation with any non-psychiatric physician. The aim of this study was to translate and validate the BDDQ into French to help plastic surgeons to detect BDD before the surgery. This way, plastic surgeons will be able to provide an optimal medical care and to reduce the risk of psychiatric collapse. Methods. - We asked Katherine Philipps for her approval to use her BDDQ for our study, and thereafter we translated it respecting the criteria of the World Health Organization. We first evaluated the psychometric qualities of the BDDQ in French and then its reproducibility and its sensitivity to change. Results. - A French version of the BDDQ appeared to be reliable and comprehensible. The questionnaire has been tested on a sample of patients in plastic surgery consultation, at a T moment and a T plus one month to certify its reproducibility and its sensitivity to change. Conclusion. - These results permit to claim that the French version of the BDDQis now validated to detect patients with a BDD in a plastic surgery consultation. (C) 2020 L'Encephale, Paris.
Our retrospective study of burn patients presents a three-step treatment of heterotopic ossification: excision surgery, early rehabilitation, and analgesia. We included patients admitted to the department for treatment of postburn heterotopic ossification between January 1, 1979, and September 30, 2015. The mean age at the time of the burn was 43.3 years. Men accounted for the majority of burn patients who developed an osteoma (70.8%). The mean total skin area burned was 38.4%. No osteoma justifying surgery was found for any patient with a total burned skin area less than 19%. The burned zones were related to the osteoma development in 94.3% of cases. On average, the surgery took place 10.8 months after the burn. The osteotomy was accompanied by surgical treatment of a contracture in 37.1% of patients. Most of the osteomata were found at the elbows (30), followed by the shoulders (3), and finally the knees (2). Rehabilitation began on D0 after the surgery, except if a flap or a thin-skin graft was used. Regarding analgesia, opiates were prescribed systematically during the immediate postoperative period. Elbow range of motion on flexion improved by a mean of 84.1°. During the postoperative period, we found 2 recurrences of osteoma and 1 elbow hematoma in two separate patients. There were no postoperative infections or neurological sequelae. Our retrospective French study confirmed results found in the international literature. The three-step treatment - excision surgery, early rehabilitation, and antalgia - seems to be the best means of treating osteoma with satisfactory results. Surgery is indicated only in the case of functional impairment and not simply based on imaging.
The prevalence of immolation by fire in France is uncertain. We carried out a retrospective epidemiological study on immolations between 2011 and 2016 at the burn treatment centre at the hôpital Saint-Louis in Paris. We studied the prevalence and characteristics of patients entering hospital for this reason. Between 2011 and 2016, a total of 1098 patients were hospitalized in the centre, of which 50 were admitted for immolation, i.e. five percent of the hospitalized population. The average age at entry was 46 years, and they were mostly men (62%). All but one was a suicide attempt. The average total burn area was 34.5%, and the average length of stay in the centre was 53 days. The products used for the immolation were mostly white spirit, alcohol or gasoline. Nine (18%) out of the 50 patients died, burned at 62.5% on average. A psychiatric history was reported in 35 patients and 21 had previously attempted suicide; nine patients were chronic alcoholics and four were drug addicts. The most frequently reported reasons for the suicide attempt were sentimental breakdown, death of a relative or financial problem. The prevalence of immolation in our study is very low compared to that found in developing countries. The majority of our cohort is composed of patients with a history of psychiatric disorders. The history of attempted suicide is also a major risk factor for committing suicidal acts by immolation. Prevention measures should be implemented to reduce this risk.