Pharmacotherapy and psychotherapy for body dysmorphic disorder

Ipser, JC; Stein, DJ

doi:10.1002/14651858.cd005332

Cited by 21 publications

(28 citation statements)

References 38 publications

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“…A Cochrane Review on BDD and a treatment practice guideline on OCD and BDD from the United Kingdom’s National Institute for Health and Clinical Excellence (National Health Service) recommend CBT and SRIs as first-line treatments for BDD 21,90. Although virtually no treatment research has been done in children and adolescents with BDD, these treatments are considered the first-line treatments for this age group 5,21,90.…”

Section: Treatment Of Bddmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

Phillips

Rogers

2011

Child and Adolescent Psychiatric Clinics of North America

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SYNOPSISBody dysmorphic disorder (BDD), a distressing or impairing preoccupation with nonexistent or slight defect(s) in appearance, usually begins during early adolescence and appears to be common in youth. BDD is characterized by substantial impairment in psychosocial functioning and markedly high rates of suicidality. Cognitive-behavioral therapy (CBT) tailored to BDD's unique features is the best tested and most promising psychosocial treatment for adults with BDD. CBT has been used for youth with BDD, but it has not been systematically developed for or tested in this age group, and there is a pressing need for this work to be done. This article focuses on CBT for BDD in adults and youth, possible adaptations for youth, and the need for treatment research in youth. We also discuss BDD's prevalence, clinical features, how to diagnose BDD in youth, recommended pharmacotherapy for BDD (serotonin-reuptake inhibitors), and treatments that are not recommended (surgery and other cosmetic treatments). Keywordsbody dysmorphic disorder; treatment; cognitive-behavioral therapy; children; adolescents Body dysmorphic disorder (BDD) is an often-severe disorder that usually begins during early adolescence and appears to be common in youth. BDD consists of preoccupation with a nonexistent or slight defect(s) in physical appearance that causes clinically significant Corresponding author for proofs and reprints:

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Section: Treatment Of Bddmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

Phillips

Rogers

2011

Child and Adolescent Psychiatric Clinics of North America

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“…Case reports, case series, and two studies using waitlist control groups provided initial, preliminary support for the effectiveness of CBT specifically developed for BDD (see Ipser, Sander, & Stein, 2009; Wilhelm, Phillips, Fama, Greenberg, & Steketee, 2011; Williams, Hadjistavropoulos, & Sharpe, 2006, for review). These preliminary studies were promising; however, conclusions about the generalizability and replicability of their results are limited by the small number of studies, small sample sizes, and restrictive inclusion criteria (see Wilhelm et al, 2011, for review).…”

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confidence: 99%

Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Randomized Controlled Trial

et al. 2014

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There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking). Thirty-six adults with BDD were randomized to 22 sessions of immediate individual CBT-BDD over 24 weeks (n = 17) or to a 12-week waitlist (n = 19). The Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS), Brown Assessment of Beliefs Scale, and Beck Depression Inventory-II were completed pre-treatment, monthly, post-treatment, and at 3- and 6-month follow-up. The Sheehan Disability Scale and Client Satisfaction Inventory (CSI) were also administered. Response to treatment was defined as ≥ 30% reduction in BDD-YBOCS total from baseline. By week 12, 50% of participants receiving immediate CBT-BDD achieved response versus 12% of waitlisted participants (p = 0.026). By post-treatment, 81% of all participants (immediate CBT-BDD plus waitlisted patients subsequently treated with CBT-BDD) met responder criteria. While no significant group differences in BDD symptom reduction emerged by week 12, by post-treatment CBT-BDD resulted in significant decreases in BDD-YBOCS total over time (d = 2.1, p <0.0001), with gains maintained during follow-up. Depression, insight, and disability also significantly improved. Patient satisfaction was high, with a mean CSI score of 87.3% (SD = 12.8%) at post-treatment. CBT-BDD appears to be a feasible, acceptable, and efficacious treatment that warrants more rigorous investigation.

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“…A growing literature—consisting of case reports, case series, and two studies using wait-list control groups (for review see Ipser, Sander, & Stein, 2009)—suggests the effectiveness of cognitive and behavioral techniques, such as cognitive restructuring and exposure and ritual prevention exercises, in reducing BDD symptoms when delivered individually (McKay et al, 1997; Neziroglu, 1996; Veale, Gournay, et al, 1996) or in a group-therapy format (Rosen, Reiter, & Orosan, 1995; Wilhelm, Otto, Lohr, & Deckersbach, 1999). In Wilhelm et al’s (1999) study of group CBT for BDD, BDD symptoms and depressive symptoms significantly improved.…”

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confidence: 99%

Modular Cognitive–Behavioral Therapy for Body Dysmorphic Disorder

et al. 2011

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This study pilot tested a newly developed modular cognitive–behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-month follow-ups. At posttreatment, BDD and related symptoms (e.g., mood) were significantly improved. Treatment gains were maintained at follow-up. A relatively low drop-out rate, high patient satisfaction ratings, and patient feedback indicated that the treatment was highly acceptable to patients. To our knowledge, this represents the first test of a broadly applicable, individual psychosocial treatment for BDD.

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Pharmacotherapy and psychotherapy for body dysmorphic disorder

Cited by 21 publications

References 38 publications

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Randomized Controlled Trial

Modular Cognitive–Behavioral Therapy for Body Dysmorphic Disorder

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