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A pilot randomized controlled trial of cognitive-behavioral therapy for adolescents with body dysmorphic disorder
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
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
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.
Keywords
body dysmorphic disorder, children, adolescents, cognitive-behavioral therapy, randomized controlled trial
Date
2015
Type
Journal article
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
Book
Volume
54
Issue
11
Page Range
895-904
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Controlled
Open
Open