Pharmacotherapy and psychotherapy for body dysmorphic disorder

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Body dysmorphic disorder (BDD) is a common and debilitating mental health condition characterized by excessive preoccupation with perceived physical flaws.
• Existing treatments for BDD include pharmacotherapy, primarily serotonin reuptake inhibitors (SRIs), and psychotherapy, notably cognitive behavioral therapy (CBT).

Purpose of the Study:

• To systematically evaluate the effectiveness of pharmacotherapy, psychotherapy, and combined treatments for individuals diagnosed with body dysmorphic disorder.

Main Methods:

• A comprehensive literature search was conducted across major databases (Cochrane, MEDLINE, PsycINFO) and trial registries up to December 2007.
• Included were randomized controlled trials (RCTs) meeting DSM or ICD criteria for BDD, comparing active treatments against control groups.
• Data extraction and quality assessment were performed independently by two reviewers, with efforts to obtain missing data.

Main Results:

• Four short-term RCTs involving 169 participants met the inclusion criteria.
• Fluoxetine demonstrated superiority over placebo in one trial, and both fluoxetine and clomipramine showed significant symptom reduction.
• Cognitive behavioral therapy (CBT) also significantly reduced symptom severity in two trials, with a low relapse rate observed in one CBT study.

Conclusions:

• Current evidence from a limited number of RCTs suggests that both SRIs and CBT may be beneficial for treating BDD.
• Replication of these findings in larger, diverse populations, including adolescents, is crucial.
• Future research should investigate other selective serotonin reuptake inhibitors (SSRIs) and various psychological therapy approaches, both individually and in combination.