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Prevalence and impact of insomnia in children and adolescents with body dysmorphic disorder undergoing multimodal specialist treatment

Sevilla-Cermeño, Laura ; Rautio, Daniel ; Andrén, Per LU ; Hillborg, Maria ; Silverberg-Morse, Maria ; Lahera, Guillermo ; Mataix-Cols, David LU and Fernández de la Cruz, Lorena (2020) In European Child and Adolescent Psychiatry 29(9). p.1289-1299
Abstract

Pediatric body dysmorphic disorder (BDD) is challenging to treat. This study aimed to establish the prevalence of insomnia in youth with BDD and explore its impact on clinical outcomes. Sixty-six children and adolescents with BDD consecutively referred to a specialist clinic completed a range of clinical measures, including the Yale-Brown Obsessive–Compulsive Scale Modified for BDD-Adolescent Version (BDD-YBOCS-A), and the Insomnia Severity Index (ISI). Patients with clinical insomnia (ISI score ≥ 9) were compared to the rest of the sample on socio-demographic and clinical features. Fifty-six patients who received multimodal treatment were re-assessed post-treatment. A mixed-model ANOVA was performed to compare treatment outcomes... (More)

Pediatric body dysmorphic disorder (BDD) is challenging to treat. This study aimed to establish the prevalence of insomnia in youth with BDD and explore its impact on clinical outcomes. Sixty-six children and adolescents with BDD consecutively referred to a specialist clinic completed a range of clinical measures, including the Yale-Brown Obsessive–Compulsive Scale Modified for BDD-Adolescent Version (BDD-YBOCS-A), and the Insomnia Severity Index (ISI). Patients with clinical insomnia (ISI score ≥ 9) were compared to the rest of the sample on socio-demographic and clinical features. Fifty-six patients who received multimodal treatment were re-assessed post-treatment. A mixed-model ANOVA was performed to compare treatment outcomes between the insomnia vs. no insomnia groups, and Chi-squared tests were used to compare response and remission rates. According to the ISI, 48% of the sample qualified as having insomnia at baseline. These participants showed significantly higher self-reported BDD symptom severity, more depressive symptoms, and more functional impairment in daily activities. Patients with insomnia improved less on the BDD-YBOCS-A than those without insomnia, although the difference did not reach statistical significance. The rates of responders and remitters were lower in the insomnia group, compared to the non-insomnia group. Insomnia is prevalent in pediatric BDD, and is associated with more severe psychopathology and worse functioning in daily activities. Furthermore, youth experiencing BDD and insomnia may benefit from multimodal treatment to a lesser extent than those without insomnia. If these results are replicated in larger samples, treatment refinements for pediatric BDD could include specific modules to directly target insomnia.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescents, Body dysmorphic disorder, Children, Cognitive-behavior therapy, Insomnia
in
European Child and Adolescent Psychiatry
volume
29
issue
9
pages
1289 - 1299
publisher
Springer
external identifiers
  • pmid:31760510
  • scopus:85075377213
ISSN
1018-8827
DOI
10.1007/s00787-019-01442-1
language
English
LU publication?
no
additional info
Publisher Copyright: © 2019, The Author(s).
id
ad26330d-8e7f-441e-8b05-6a832afd6e34
date added to LUP
2023-07-14 11:39:49
date last changed
2024-04-05 21:07:44
@article{ad26330d-8e7f-441e-8b05-6a832afd6e34,
  abstract     = {{<p>Pediatric body dysmorphic disorder (BDD) is challenging to treat. This study aimed to establish the prevalence of insomnia in youth with BDD and explore its impact on clinical outcomes. Sixty-six children and adolescents with BDD consecutively referred to a specialist clinic completed a range of clinical measures, including the Yale-Brown Obsessive–Compulsive Scale Modified for BDD-Adolescent Version (BDD-YBOCS-A), and the Insomnia Severity Index (ISI). Patients with clinical insomnia (ISI score ≥ 9) were compared to the rest of the sample on socio-demographic and clinical features. Fifty-six patients who received multimodal treatment were re-assessed post-treatment. A mixed-model ANOVA was performed to compare treatment outcomes between the insomnia vs. no insomnia groups, and Chi-squared tests were used to compare response and remission rates. According to the ISI, 48% of the sample qualified as having insomnia at baseline. These participants showed significantly higher self-reported BDD symptom severity, more depressive symptoms, and more functional impairment in daily activities. Patients with insomnia improved less on the BDD-YBOCS-A than those without insomnia, although the difference did not reach statistical significance. The rates of responders and remitters were lower in the insomnia group, compared to the non-insomnia group. Insomnia is prevalent in pediatric BDD, and is associated with more severe psychopathology and worse functioning in daily activities. Furthermore, youth experiencing BDD and insomnia may benefit from multimodal treatment to a lesser extent than those without insomnia. If these results are replicated in larger samples, treatment refinements for pediatric BDD could include specific modules to directly target insomnia.</p>}},
  author       = {{Sevilla-Cermeño, Laura and Rautio, Daniel and Andrén, Per and Hillborg, Maria and Silverberg-Morse, Maria and Lahera, Guillermo and Mataix-Cols, David and Fernández de la Cruz, Lorena}},
  issn         = {{1018-8827}},
  keywords     = {{Adolescents; Body dysmorphic disorder; Children; Cognitive-behavior therapy; Insomnia}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{9}},
  pages        = {{1289--1299}},
  publisher    = {{Springer}},
  series       = {{European Child and Adolescent Psychiatry}},
  title        = {{Prevalence and impact of insomnia in children and adolescents with body dysmorphic disorder undergoing multimodal specialist treatment}},
  url          = {{http://dx.doi.org/10.1007/s00787-019-01442-1}},
  doi          = {{10.1007/s00787-019-01442-1}},
  volume       = {{29}},
  year         = {{2020}},
}