The urge to change appearance in different psychopathological categories

Abstract

Background:In professional literature, mainly anecdotic descriptions can be found of striking, sometimes even bizarre manipulations of the appearance by psychiatric patients.Objective:In this study, it was examined whether the inclination to (drastically) change the appearance is related to (pre)psychotic symptoms.Methods:By means of a questionnaire, the frequency and nature of changing the appearance was studied among a sample of healthy volunteers (n = 38) and psychiatric patients (n = 61). The psychiatric group consisted of 1) patients with schizophrenia (n = 22), 2) patients with a borderline personality disorder (n = 20) and 3) patients with a depressive disorder (n = 19).Results:In accordance with previous findings, self-reports of drastic changes of appearance were associated with scores on various schizotypy scales. Psychiatric patients reported more changes of appearance, compared with healthy volunteers. Patients with schizophrenia reported most changes, followed by the group of patients with borderline personality disordered.Conclusions:Perhaps, drastic changes of the appearance are a visible expression of the loss of ego boundaries and/or of the sense of reality.