Metacognitive Therapy for Body Dysmorphic Disorder: A Consecutive Case Series

Background: Research suggests that metacognitions could be important in explaining symptoms of body dysmorphic disorder (BDD), but the effect of metacognitive therapy (MCT) on BDD is unknown. Method: The aim of this consecutive case series was to explore MCT for BDD, delivered individually within a public mental health setting. Treatment was based on MCT manuals for obsessive-compulsive disorder and generalized anxiety disorder. Of 11 eligible participants, 2 declined treatment, 8 completed treatment, and 1 dropped out. Results: MCT for BDD was associated with significant reductions in BDD symptoms, comorbid symptoms of depression and anxiety, and metacognitions. All treatment completers were characterized as treatment responders (i.e., >30% improvement), and improvements were maintained at 3-month follow-up. Conclusions: MCT could be a promising treatment for BDD. Future studies should explore MCT for BDD in controlled trials and explore how to motivate individuals with BDD for psychological treatment.