Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

Behav Ther. 2017 Jul;48(4):462-473. doi: 10.1016/j.beth.2017.01.001. Epub 2017 Jan 10.

Abstract

Emerging evidence suggests that cognitive-behavioral therapy (CBT) is an efficacious treatment for adolescent body dysmorphic disorder (BDD) in the short term, but longer-term outcomes remain unknown. The current study aimed to follow up a group of adolescents who had originally participated in a randomized controlled trial of CBT for BDD to determine whether treatment gains were maintained. Twenty-six adolescents (mean age = 16.2, SD = 1.6) with a primary diagnosis of BDD received a course of developmentally tailored CBT and were followed up over 12 months. Participants were assessed at baseline, midtreatment, posttreatment, 2-, 6-, and 12-month follow-up. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD. Secondary outcomes included measures of insight, depression, quality of life, and global functioning. BDD symptoms decreased significantly from pre- to posttreatment and remained stable over the 12-month follow-up. At this time point, 50% of participants were classified as responders and 23% as remitters. Participants remained significantly improved on all secondary outcomes at 12-month follow-up. Neither baseline insight nor baseline depression predicted long-term outcomes. The positive effects of CBT appear to be durable up to 12-month follow-up. However, the majority of patients remained symptomatic and vulnerable to a range of risks at 12-month follow-up, indicating that longer-term monitoring is advisable in this population. Future research should focus on enhancing the efficacy of CBT in order to improve long-term outcomes.

Keywords: adolescents; body dysmorphic disorder; children; cognitive-behavioral therapy.

MeSH terms

  • Adolescent
  • Body Dysmorphic Disorders / psychology
  • Body Dysmorphic Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Depression / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Time*
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN67699666