Psychological implications for patients with bromhidrosis

KATAOKA, ALEXANDRE; MENDES, CAMILA CRISTINA SILVA

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Revista Brasileira de Cirurgia Plástica

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Brasil

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Sumário

Original Article • Rev. Bras. Cir. Plást. 36 (04) • 2021 • https://doi.org/10.5935/2177-1235.2021RBCP0130 copy

Psychological implications for patients with bromhidrosis

Authorship SCIMAGO INSTITUTIONS RANKINGS

■ ABSTRACT

Introduction:

Bromhidrosis or osmidrosis is a problem that leads many patients to seek specialized medical treatment. This work aims to show that the bromhidrosis disease is also related to the emotional one, which can trigger serious psychological disorders.

Methods:

Patients of both genders, predominantly aged between 22 and 42 years, were submitted to consultations and psychological assessments in the preoperative period and psychological follow-up in the postoperative period.

Results:

Of the 34 patients evaluated who had a diagnosis of bromhidrosis, 23 had symptoms of severe depression.

Conclusion:

Patients diagnosed with bromhidrosis are emotionally vulnerable, depressed and anxious. Without proper treatment, it can lead to serious personality disorders.

Keywords:
Depression; Psychological anguish; Sweat gland diseases; Sweat; Reconstructive surgical procedures

SYMPTOMS	Affirmations about depressive symptoms
1-Sadness	0 I don’t feel sad. (3 patients) 1 I feel sad a lot of the time. (27 patients) 2 I am sad all the time. (2 patients) 3 I am so sad or so unhappy that I cannot bear it. (2 patients)
2- Pessimism	0 I am not discouraged about my future. (10 patients) 1 I feel more discouraged about my future than usual. (8 patients). 2 I don’t expect things to work out for me. (5 patients) 3 I feel there is no hope for my future. I think it will only get worse. (11 patients)
3- Past failure	0 I don’t feel like a failure. (6 patients) 1 I have failed more than I should. (7 patients) 2 When I think about the past, I see many failures. (15 patients) 3 I feel that as a person, I am a total failure. (6 patients)
4-Loss of Pleasure	0 I continue to feel the same pleasure I used to get from the things I like. (5 patients) 1 I don’t get as much pleasure from things as I used to. (16 patients) 2 I take very little pleasure in the things I used to enjoy. (10 patients) 3 I no longer enjoy the things I used to like. (3 patients)
5-Feeling of guilt	0 I don’t feel particularly guilty. (7 patients) 1 I feel guilty about many things I have done and/or should have done. (12 patients) 2 I feel guilty most of the time. (11 patients) 3 I feel guilty all the time. (4 patients)
6-Feeling of punishment	0 I don’t feel like I’m being punished. (7 patients) 1 I feel I can be punished. (8 patients) 2 I think I will be punished. (4 patients) 3 I feel like I’m being punished. (15 patients)
7-Self-esteem	0 I feel the way I always felt about myself. (6 patients) 1 I lost confidence in myself. (11 patients) 2 I’m disappointed in myself. (9 patients) 3 I don’t like me. (8 patients)
8-Self-criticism	0 I don’t criticize or blame myself more than usual. (7 patients) 1 I’m being more critical of myself than I used to be. (5 patients) 2 I criticize myself for all my mistakes. (13 patients) 3 I blame myself for everything bad that happens. (9 patients)
9-Suicidal thoughts or desires	0 I have no thoughts of killing myself. (14 patients) 1 I have ideas of killing myself, but I wouldn’t go through with it. (17 patients) 2 I would like to kill myself. (1 patient) 3 I would kill myself if given a chance. (5 patients)
10-Cry	0 I don’t cry any more than I used to cry. (5 patients) 1 I cry more now than I used to. (4 patients) 2 cries for anything. (15 patients) 3 I feel like crying, but I can’t. (10 patients)
11-Agitation	0 I don’t feel any more restless or agitated than I used to feel. (5 patients) 1 I feel more restless or agitated than I felt before. (10 patients) 2 I feel so restless or agitated that it’s hard to sit still. (11 patients) 3 I’m so restless or agitated that I always have to be moving or doing something. (6 patients)
12-Loss of interest	0 I haven’t lost interest in other people or my activities. (3 patients) 1 I am less interested in other people or things than I used to be. (7 patients) 2 I have lost almost all interest in other people or things. (18 patients) 3 It’s hard to get interested in anything. (6 patients)
13-Indecision	0 I make my decisions as well as before. (4 patients) 1 I find it harder to make decisions now than before. (4 patients) 2 I have a lot more difficulty making decisions now than I did before. (3 patients) 3 I have difficulty making any decision. (23 patients)
14- Devaluation	0 I don’t feel worthless. (7 patients) 1 I don’t consider myself as useful today or value myself as I used to. (4 patients) 2 I feel less valuable when I compare myself to other people. (15 patients) 3 I feel completely worthless. (8 patients)
15-Energy	0 I have as much energy today as I ever had. (4 patients) 1 I have less energy than I used to have. (10 patients) 2 I don’t have enough energy to do much. (17 patients) 3 I don’t have enough energy for anything. (3 patients)
16-Change in sleep pattern	0 I didn’t notice any change in my sleep. (5 patients) 1a I sleep a little longer than usual. (9 patients) 1b I sleep a little less than usual. (2 patients) 2a I sleep a lot more than usual. (5 patients) 2b I sleep much less than usual. (9 patients) 3a I sleep most of the day. (3 patients) 3b I wake up 1 or 2 hours early and can’t go back to sleep. (1 patient)
17-Irritability	0 I’m not angrier than usual. (5 patients) 1 I am angrier than usual. (3 patients) 2 I am much angrier than usual. (14 patients) 3 I get irritated all the time. (12 patients)
18-Appetite changes	0 I didn’t notice any change in my appetite. (3 patients) 1a My appetite is a little less than usual. (8 patients) 1b My appetite is a little bigger than usual. (5 patients) 2nd My appetite is much smaller than before. (1 patient) 2b My appetite is much bigger than before. (7 patients) 3rd I have no appetite. (9 patients) 3b I want to eat all the time. (1 patient)
19-Difficulty concentrating	0 I can concentrate as well as before. (4 patients) 1 I can’t concentrate as well as usual. (2 patients) 2 It is very difficult to stay focused on something for a long time. (27 patients) 3 I don’t think I can concentrate on anything. (1 patient)
20- Tiredness or fatigue	0 I am no more tired or fatigued than usual. (2 patients) 1 I get tired or fatigued more easily than usual. (11 patients) 2 I feel too tired or fatigued to do many of the things I used to do. (7 patients) 3 I feel too tired or fatigued to do most of the things I used to do. (14 patients)
21-Loss of interest in sex	0 I haven’t noticed any recent changes in my interest in sex. (6 patients) 1 I’m less interested in sex than I used to be. (11 patients) 2 I’m much less interested in sex now. (17 patients) 3 I completely lost interest in sex.

	BDI-II DEPRESSION INVENTORY
SYMPTOMS	ANSWERS RELATED TO THE SYMPTOMS THAT MOST PREVAILED
Sadness	I feel sad a lot of the time.
Difficulty in Concentration	It's very difficult to stay focused on something for a long time.
Indecision	I have difficulty making any decision.
Loss of interest	I almost lost interest in other people or things.
Suicidal thoughts or wishes	I have thoughts of killing myself, but I wouldn't go through with it.
Lack of energy	I don't have enough energy to do much.
Loss of interest in sex	I'm much less interested in sex now.
Loss of pleasure	I don't get as much pleasure from things as I used to.
Past failure	When I think about the past, I see many failures.
Cry	I cry for anything.
Devaluation	I feel less valuable when I compare myself to other people.
Feelings of punishment	I feel like I'm being punished.
Irritability	I'm much angrier than usual.
Tiredness or fatigue	I feel too tired or fatigued to do most of the things I used to do.
Self-criticism	I criticize myself for all my mistakes.
Guilt	I feel guilty about a lot of things I've done and/or should have done.
Pessimism	I feel there is no hope for my future. I think it will only get worse.
Self-esteem	I lost confidence in myself.
agitation	I feel so restless or agitated that it's hard to sit still.
Change in sleep pattern	-I sleep a little longer than usual. -I sleep less than usual.
Appetite change	I have no appetite.

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[1] Conflicts of interest: none.