Penile Dysmorphic Disorder: Development of a Screening Scale

Abstract

Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population.

Erect Penile Dimensions in a Cohort of 778 Middle Eastern Men: Establishment of a Nomogram

“…Measurement of penile size is of course only one aspect of assessment of men with SPA or a micropenis. Equally as important is male genital image satisfaction [16], an understanding of the beliefs and attitudes about penile size [7], and the need to screen for BDD when it is focused on penile size [17].…”

Environmental and physical risk factors for men to develop body dysmorphic disorder concerning penis size compared to men anxious about their penis size and men with no concerns: A cohort study

“…Cosmetic Procedure Screening Scale for BDD related to penile appearance (COPS-P) (Veale et al, 2015a). The COPS-P is a 9 item scale (range 0-72) based on the original COPS for general appearance concerns , which is validated as a screening questionnaire for identifying BDD.…”

Patient selection protocol for the Penuma® implant: suggested preoperative evaluation for aesthetic surgery of the penis

“…(1) Several validated questionnaires help evaluate the subject's self-image, distress level, functional impairment, and BDD. These questionnaires include the Cosmetic Procedure Screening Scale for PDD [2], BDD Modification of the Yale-Brown OCS [11], Belief About Penis Size Questionnaire [12], and the Male Genital Self-Image Scale [13]. Based on the clinic's review of the patient's responses, patients may be referred to a mental health professional to assess psychological appropriateness for the surgery.…”

“…Patient selection for the Penuma implant considers the patient's health status, history of the underlying issue(s) for which he seeks help, and the complexity of his particular habitus. Most importantly we seek assessment of his psychological state, particularly perceived body image distortion, including small penis anxiety and penile dysmorphic disorder (PDD), which is a variant of body dysmorphic disorder (BDD) [2] Patients with BDD have consistently been identified as having a higher likelihood of unsatisfactory outcomes from most aesthetic surgeries [3][4][5][6][7][8].…”