Harrison, A;
Fernandez de la Cruz, L;
Enander, J;
Radua, J;
Mataix-Cols, D;
(2016)
Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials.
Clinical Psychology Review
, 48
pp. 43-51.
10.1016/j.cpr.2016.05.007.
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Abstract
Body dysmorphic disorder (BDD) is a chronic and disabling psychiatric disorder unlikely to remit without treatment. A systematic review and meta-analysis of randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) for BDD was conducted, including published and unpublished trials to 26th November 2015. Primary outcomes were validated BDD measures; secondary outcomes included depression and insight. Meta-regressions were conducted to examine potential effects of variables on the primary outcome, including socio-demographic variables, comorbidity, symptom severity/duration, concomitant medication, treatment duration, and methodological quality of the RCTs. Seven RCTs (N = 299) met inclusion criteria. CBT was superior to waitlist or credible psychological placebo in reducing BDD (7 studies; delta = − 1.22, 95% CI = − 1.66 to − 0.79) and depression symptoms (5 studies; delta = − 0.49, 95% CI = − 0.76 to − 0.22). CBT was associated with improvements in insight/delusionality (4 studies; delta = − 0.56, 95% CI = − 0.93 to − 0.19). Improvement in BDD was maintained after 2–4 months follow-up (3 studies; delta = − 0.89, 95% CI = − 1.24 to − 0.54). Meta-regression analyses did not reveal any significant predictors of outcome. CBT is an efficacious treatment for BDD but there is substantial room for improvement. The specificity and long-term effects of CBT for BDD require further evaluation using credible control conditions. Additional trials comparing CBT with pharmacological therapies, as well as their combination, are warranted. Tele-care options, such as Internet-based CBT, hold great promise to increase access to evidence-based treatment for a majority of patients who need it and should be evaluated further.
| Type: | Article |
|---|---|
| Title: | Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.cpr.2016.05.007 |
| Publisher version: | http://dx.doi.org/10.1016/j.cpr.2016.05.007 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Social Sciences, Psychology, Clinical, Psychology, Body dysmorphic disorder, Cognitive-behavioral therapy, Treatment, Meta-analysis, Systematic review, Randomized controlled trial, OBSESSIVE-COMPULSIVE DISORDER, POPULATION-BASED SURVEY, DEPRESSION SCALE, FOLLOW-UP, PREVALENCE, EFFICACY, PHARMACOTHERAPY, AUGMENTATION, RELIABILITY, FLUOXETINE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10057565 |
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