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Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials

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. Green open access

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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controlled trials (RCTs) of cognitive-behavioral therapy (CBT) for BDD was conducted, including published and unpublished trials to 26th November 2015.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
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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