Effects of Pharmacological and Psychological Treatments on Depressive Symptoms in Body Dysmorphic Disorder: A...

This systematic review and meta-analysis evaluated the effects of pharmacological and psychological treatments on depressive symptoms in individuals with body dysmorphic disorder (BDD). The primary objective was to assess treatment-related changes in depressive symptom severity among patients with BDD, while evidence regarding dysmorphic symptoms and combined interventions was reviewed narratively and should be interpreted with caution.

Across 46 studies (N = 2,227), evidence suggests antidepressants-especially SSRIs-substantially reduce depressive symptoms. Cognitive-behavioral therapy (CBT) also shows large effects, though variability across trials remains high. Most research includes small samples and heterogeneous designs, underscoring the need for consistency. Pharmacological treatment yielded a pooled standardized mean difference (SMD) of -0.96 (95% CI [-1.37,-0.54], p < 0.001), with SSRIs showing the greatest improvement (SMD =-1.16). CBT demonstrated comparable efficacy (SMD = -1.12), remaining significant after bias correction (SMD = -0.65). Combined approaches may provide optimal outcomes. Future research should focus on large, standardized RCTs evaluating functional recovery and suicide risk reduction.