A pilot randomized controlled trial of cognitive-behavioral therapy for adolescents with body dysmorphic disorder

Journal article


Mataix-Cols, David, de la Cruz, Lorena Fernández, Isomura, Kayoko, Anson, Martin, Turner, Cynthia Michelle, Monzani, Benedetta, Cadman, Jacinda, Bowyer, Laura, Heyman, Isobel, Veale, David and Krebs, Georgina 2015. A pilot randomized controlled trial of cognitive-behavioral therapy for adolescents with body dysmorphic disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 54 (11), pp. 895 - 904. https://doi.org/10.1016/j.jaac.2015.08.011
AuthorsMataix-Cols, David, de la Cruz, Lorena Fernández, Isomura, Kayoko, Anson, Martin, Turner, Cynthia Michelle, Monzani, Benedetta, Cadman, Jacinda, Bowyer, Laura, Heyman, Isobel, Veale, David and Krebs, Georgina
Abstract

Objective: Body dysmorphic disorder (BDD) typically starts in adolescence, but evidence-based treatments are yet to be developed and formally evaluated in this age group. We designed an age-appropriate cognitive-behavioral therapy (CBT) protocol for adolescents with BDD and evaluated its acceptability and efficacy in a pilot randomized controlled trial. Method: Thirty adolescents aged 12 to 18 years (mean = 16.0, SD = 1.7) with a primary diagnosis of BDD, together with their families, were randomly assigned to 14 sessions of CBT delivered over 4 months or a control condition of equivalent duration, consisting of written psycho-education materials and weekly telephone monitoring. Blinded evaluators assessed participants at baseline, midtreatment, posttreatment, and at 2-month follow-up. The primary outcome measure was the Yale−Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent Version (mean baseline score = 37.13, SD = 4.98, range = 24–43). Results: The CBT group showed a significantly greater improvement than the control group, both at posttreatment (time × group interaction coefficient [95% CI] = −11.26 [−17.22 to −5.31]; p = .000) and at 2-month follow-up (time × group interaction coefficient [95% CI] = −9.62 [−15.74 to −3.51]; p = .002). Six participants (40%) in the CBT group and 1 participant (6.7%) in the control condition were classified as responders at both time points (χ2 = 4.658, p = .031). Improvements were also seen on secondary measures, including insight, depression, and quality of life at posttreatment. Both patients and their families deemed the treatment as highly acceptable. Conclusion: Developmentally tailored CBT is a promising intervention for young people with BDD, although there is significant room for improvement. Further clinical trials incorporating lessons learned in this pilot study and comparing CBT and pharmacological therapies, as well as their combination, are warranted.

Keywordsbody dysmorphic disorder; children; adolescents; cognitive-behavioral therapy; randomized controlled trial
Year2015
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Journal citation54 (11), pp. 895 - 904
PublisherElsevier Inc.
ISSN0890-8567
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jaac.2015.08.011
Scopus EID2-s2.0-84944883108
Open accessOpen access
Page range895 - 904
Research GroupSchool of Philosophy
Author's accepted manuscript
Place of publicationUnited States of America
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