A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder - 23/10/15
, Lorena Fernández de la Cruz, PhD a, Kayoko Isomura, MD, PhD a, Martin Anson, PhD b, c, Cynthia Turner, PhD d, Benedetta Monzani, PhD b, Jacinda Cadman, DClinPsych e, Laura Bowyer, DClinPsych c, Isobel Heyman, MBBS, PhD b, f, David Veale, MD b, c, Georgina Krebs, DClinPsych b, cAbstract |
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.
Clinical Trial Registration Information—Cognitive-Behaviour Therapy for Adolescents With Body Dysmorphic Disorder; www.isrctn.com/; ISRCTN67699666.
Le texte complet de cet article est disponible en PDF.Key Words : Body dysmorphic disorder, children, adolescents, cognitive-behavioral therapy, randomized controlled trial
Plan
| The study was funded by the National Institute for Health Research under its Research for Patient Benefit (RfPB) Programme (grant reference number PB-PG-0110-21231). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Dr. Fernández de la Cruz was supported by a Short-Term Visiting Fellowship from the Alicia Koplowitz Foundation. Dr. Veale acknowledges salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. |
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| Disclosure: Drs. Mataix-Cols, Fernández de la Cruz, Isomura, Anson, Turner, Monzani, Cadman, Bowyer, Heyman, Veale, and Krebs report no biomedical financial interests or potential conflicts of interest. |
Vol 54 - N° 11
P. 895-904 - novembre 2015 Retour au numéro
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