David Mataix-Cols1, Lorena Fernández de la Cruz2, Kayoko Isomura2, Martin Anson3, Cynthia Turner4, Benedetta Monzani5, Jacinda Cadman6, Laura Bowyer7, Isobel Heyman8, David Veale3, Georgina Krebs3. 1. Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Stockholm; King's College London, Institute of Psychiatry, Psychology and Neuroscience, London; South London and Maudsley National Health Service (NHS) Foundation Trust, London. Electronic address: david.mataix.cols@ki.se. 2. Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Stockholm. 3. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London; South London and Maudsley National Health Service (NHS) Foundation Trust, London. 4. University of Queensland, Brisbane, Australia. 5. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London. 6. Griffith University, Gold Coast, Australia. 7. South London and Maudsley National Health Service (NHS) Foundation Trust, London. 8. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London; Great Ormond Street Hospital, London and Institute of Child Health, University College London.
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 (χ(2) = 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. CLINICAL TRIAL REGISTRATION INFORMATION: Cognitive-Behaviour Therapy for Adolescents With Body Dysmorphic Disorder; http://www.isrctn.com/; ISRCTN67699666.
RCT Entities:
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 (χ(2) = 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. CLINICAL TRIAL REGISTRATION INFORMATION: Cognitive-Behaviour Therapy for Adolescents With Body Dysmorphic Disorder; http://www.isrctn.com/; ISRCTN67699666.
Authors: Laura Sevilla-Cermeño; Daniel Rautio; Per Andrén; Maria Hillborg; Maria Silverberg-Morse; Guillermo Lahera; David Mataix-Cols; Lorena Fernández de la Cruz Journal: Eur Child Adolesc Psychiatry Date: 2019-11-23 Impact factor: 4.785
Authors: Jesper Enander; Erik Andersson; David Mataix-Cols; Linn Lichtenstein; Katarina Alström; Gerhard Andersson; Brjánn Ljótsson; Christian Rück Journal: BMJ Date: 2016-02-02
Authors: Jesper Enander; Volen Z Ivanov; David Mataix-Cols; Ralf Kuja-Halkola; Brjánn Ljótsson; Sebastian Lundström; Ana Pérez-Vigil; Benedetta Monzani; Paul Lichtenstein; Christian Rück Journal: Psychol Med Date: 2018-02-28 Impact factor: 7.723
Authors: Don A Vaughn; Wesley T Kerr; Teena D Moody; Gigi K Cheng; Francesca Morfini; Aifeng Zhang; Alex D Leow; Michael A Strober; Mark S Cohen; Jamie D Feusner Journal: PLoS One Date: 2019-05-06 Impact factor: 3.240
Authors: Lorena Fernández de la Cruz; Jesper Enander; Christian Rück; Sabine Wilhelm; Katharine A Phillips; Gail Steketee; Suraj Sarvode Mothi; Georgina Krebs; Laura Bowyer; Benedetta Monzani; David Veale; David Mataix-Cols Journal: Psychol Med Date: 2019-10-30 Impact factor: 7.723