Systemic Symptoms Associated with Breast Implants (SSBI)- Beliefs and Emotions Study
Systemic Symptoms Associated with Breast Implants (SSBI) is a term used to describe a variety of symptoms self-reported by some patients with breast implants. Recent published literature demonstrates a lack of biospecimen findings to explain the systemic symptoms reported. Physical symptoms are considered to be associated with poor health but are a common experience in the general population. Although most reported systemic symptoms are transient, such symptoms are a leading cause of medical visits where no real underlying disease diagnosis is identified. Patients who report a high number of somatic symptoms may have underlying psychiatric disorders including Somatic Symptom Disorder (SSD) that can predict impaired health. SSD involves the experience of one or more physical symptoms with excessive thoughts, feelings, and behaviors directed towards these symptoms.
This study evaluates psychological factors in SSBI from two perspectives. First, comparing the SSBI cohort (patients who attribute their systemic symptoms to their breast implants), to two control cohorts, Non-SSBI (women with breast implants seeking removal or exchange who do not attribute systemic symptoms to their implants), and a mastopexy control group who have no implanted medical device, in terms of their symptoms, emotions, and experiences. This systematic assessment compares psychological differences between these groups that might contribute to SSBI. Second, by further exploring the beliefs and experiences of participants with self-identified SSBI cohort, this study explores whether particular beliefs about SSBI are associated with increased symptom burden.
Methods/Technique:
Patients completed the online study questionnaire in-person, prior to meeting with the investigator physician, to eliminate any biases resulting from the physician-patient consultation. Eligible genetic females between 22-65 years of age were sequentially enrolled in one of the three cohorts at 8 investigator sites in the US and UK. Data collection included demographics, surgery-related information, and other diagnoses before or after onset of BII symptoms. Survey questions included nine well-studied validated surveys used to evaluate the relationship between symptoms, beliefs, and experiences. Data collection was conducted using Qualtrics software.
Results/Complications:
Collected data was evaluated by PhD psychologists who specialize in Medically Unexplained Symptoms and Somatic Symptom Disorders. A total of 265 subjects completed the in-office surveys, including 105 SSBI, 84 Non-SSBI, and 76 mastopexy patients. The proportion of participants in the SSBI cohort who meet the criteria for SSD was significantly higher than both controls and is consistent with our previously published studies. The SSBI cohort reported significantly more symptoms, heightened anxiety and depression, and demonstrated significantly higher scores on psychological measures associated with SSD, including heightened negative affect, catastrophizing, and somatosensory amplification.
Conclusion: s:
Utilizing 9 validated psychological questionnaires, the data demonstrates that subjects in the SSBI cohort are significantly more likely to meet criteria for diagnosis of SSD, and report more negative thoughts and feelings relating to their experience of physical symptoms. These negative thoughts and feelings may contribute to the development and maintenance of SSBI, though longitudinal research is needed to assess these relationships further.