Updating theoretical frameworks in body dysmorphic disorder: A systematic review and meta-analysis

Area of Science:

• Psychiatry
• Psychology
• Mental Health

Background:

• Existing research on body dysmorphic disorder (BDD) lacks integration between real-world data and theoretical models.
• There is a need for an updated theoretical framework to empirically support the understanding of BDD.

Purpose of the Study:

• To refine and empirically support the conceptual understanding of BDD.
• To develop an updated theoretical framework for BDD by synthesizing existing data.

Main Methods:

• Systematic literature search of major databases (PubMed, Embase, CENTRAL, Scopus, Web of Science) up to November 26, 2023.
• Analysis of 24 studies involving 961 BDD patients and 230,076 controls.
• Qualitative analysis and random-effects meta-analysis, followed by critical appraisal and theoretical integration.

Main Results:

• Marriage identified as a protective factor for BDD (pooled risk ratio 0.67, P = .004).
• Heterogeneity precluded pooling of factors like teasing, abuse, attractiveness beliefs, self-esteem, and other psychological conditions.
• Findings align with cognitive behavioral models, contributing to an updated theoretical framework and identifying research gaps.

Conclusions:

• Recognizing and understanding BDD is crucial for effective therapy targeting underlying psychological components.
• Further research is recommended to explore the interplay between cognitive and behavioral aspects of BDD.