Effectiveness of Multimodal Treatment for Young People With Body Dysmorphic Disorder in Two Specialist Clinics
(2022) In Behavior Therapy 53(5). p.1037-1049- Abstract
Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvement. We followed 140 young people (age range 10–18) with a diagnosis of BDD treated at two national and specialist outpatient clinics in Stockholm, Sweden (n = 96) and London, England (n = 44), between January 2015 and April 2021. Participants received multimodal treatment consisting of cognitive behavior therapy and, in 72% of cases,... (More)
Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvement. We followed 140 young people (age range 10–18) with a diagnosis of BDD treated at two national and specialist outpatient clinics in Stockholm, Sweden (n = 96) and London, England (n = 44), between January 2015 and April 2021. Participants received multimodal treatment consisting of cognitive behavior therapy and, in 72% of cases, medication (primarily selective serotonin reuptake inhibitors). Data were collected at baseline, posttreatment, and 3, 6, and 12 months after treatment. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent version (BDD-YBOCS-A). Secondary outcomes included self-reported measures of BDD symptoms, depressive symptoms, and global functioning. Mixed-effects regression models showed that BDD-YBOCS-A scores decreased significantly from baseline to posttreatment (coefficient [95% confidence interval] = -16.33 [-17.90 to -14.76], p<0.001; within-group effect size (Cohen's d) = 2.08 (95% confidence interval, 1.81 to 2.35). At the end of the treatment, 79% of the participants were classified as responders and 59% as full or partial remitters. BDD symptoms continued to improve throughout the follow-up. Improvement was also seen on all secondary outcome measures. Linear regression models identified baseline BDD symptom severity as a predictor of treatment outcome at posttreatment, but no consistent predictors were found at the 12-month follow-up. To conclude, multimodal treatment for adolescent BDD is effective in both the short- and long-term when provided flexibly within a specialist setting. Considering the high personal and societal costs of BDD, specialist care should be made more widely available.
(Less)
- author
- publishing date
- 2022-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- adolescents, body dysmorphic disorder, cognitive-behavior therapy, dysmorphophobia, treatment outcomes
- in
- Behavior Therapy
- volume
- 53
- issue
- 5
- pages
- 1037 - 1049
- publisher
- Elsevier
- external identifiers
-
- pmid:35987534
- scopus:85131841752
- ISSN
- 0005-7894
- DOI
- 10.1016/j.beth.2022.04.010
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2022
- id
- 7916bbff-eabd-4b13-bb2f-7bac17bb15b1
- date added to LUP
- 2023-07-14 11:30:03
- date last changed
- 2024-07-28 09:12:22
@article{7916bbff-eabd-4b13-bb2f-7bac17bb15b1, abstract = {{<p>Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvement. We followed 140 young people (age range 10–18) with a diagnosis of BDD treated at two national and specialist outpatient clinics in Stockholm, Sweden (n = 96) and London, England (n = 44), between January 2015 and April 2021. Participants received multimodal treatment consisting of cognitive behavior therapy and, in 72% of cases, medication (primarily selective serotonin reuptake inhibitors). Data were collected at baseline, posttreatment, and 3, 6, and 12 months after treatment. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent version (BDD-YBOCS-A). Secondary outcomes included self-reported measures of BDD symptoms, depressive symptoms, and global functioning. Mixed-effects regression models showed that BDD-YBOCS-A scores decreased significantly from baseline to posttreatment (coefficient [95% confidence interval] = -16.33 [-17.90 to -14.76], p<0.001; within-group effect size (Cohen's d) = 2.08 (95% confidence interval, 1.81 to 2.35). At the end of the treatment, 79% of the participants were classified as responders and 59% as full or partial remitters. BDD symptoms continued to improve throughout the follow-up. Improvement was also seen on all secondary outcome measures. Linear regression models identified baseline BDD symptom severity as a predictor of treatment outcome at posttreatment, but no consistent predictors were found at the 12-month follow-up. To conclude, multimodal treatment for adolescent BDD is effective in both the short- and long-term when provided flexibly within a specialist setting. Considering the high personal and societal costs of BDD, specialist care should be made more widely available.</p>}}, author = {{Rautio, Daniel and Gumpert, Martina and Jassi, Amita and Krebs, Georgina and Flygare, Oskar and Andrén, Per and Monzani, Benedetta and Peile, Lauren and Jansson-Fröjmark, Markus and Lundgren, Tobias and Hillborg, Maria and Silverberg-Mörse, Maria and Clark, Bruce and Fernández de la Cruz, Lorena and Mataix-Cols, David}}, issn = {{0005-7894}}, keywords = {{adolescents; body dysmorphic disorder; cognitive-behavior therapy; dysmorphophobia; treatment outcomes}}, language = {{eng}}, number = {{5}}, pages = {{1037--1049}}, publisher = {{Elsevier}}, series = {{Behavior Therapy}}, title = {{Effectiveness of Multimodal Treatment for Young People With Body Dysmorphic Disorder in Two Specialist Clinics}}, url = {{http://dx.doi.org/10.1016/j.beth.2022.04.010}}, doi = {{10.1016/j.beth.2022.04.010}}, volume = {{53}}, year = {{2022}}, }