Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder : A feasibility trial with long-term follow-up
(2023) In Internet Interventions 34.- Abstract
Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12–17-year-olds) meeting criteria for BDD were recruited nationally to a specialist... (More)
Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12–17-year-olds) meeting criteria for BDD were recruited nationally to a specialist outpatient clinic in Stockholm, Sweden. One participant withdrew consent and their data could not be analysed. Nineteen participants were offered 12 modules of therapist-guided ICBT for BDD and were followed up to 12 months post-treatment. Preliminary efficacy was measured at the a priori primary endpoint (3-month follow-up) and at the 12-month follow-up with the clinician-rated Yale-Brown Obsessive Compulsive Scale Modified for BDD for Adolescents. The treatment was rated as both credible and satisfactory and was associated with a large and statistically significant reduction in BDD symptom severity (d = 2.94). The proportion of participants classified as responders at the primary endpoint was 73.7%, and the proportion of full or partial remitters was 63.2%. The average therapist support time was 8 min per participant per week. Treatment gains continued to accrue up to the 12-month follow-up. Two participants attempted suicide and another two reported non-suicidal self-injuries during the study period. ICBT with minimal therapist support is a feasible, potentially efficacious, and durable treatment for adolescents with BDD. Risky behaviours typical of this patient group should be carefully monitored during treatment.
(Less)
- author
- organization
- publishing date
- 2023-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adolescents, Body dysmorphic disorder, Cognitive behaviour therapy, Dysmorphophobia, Evidence-based interventions, Internet-based treatment, Treatment outcomes
- in
- Internet Interventions
- volume
- 34
- article number
- 100688
- publisher
- Elsevier
- external identifiers
-
- pmid:38034863
- scopus:85178181115
- ISSN
- 2214-7829
- DOI
- 10.1016/j.invent.2023.100688
- language
- English
- LU publication?
- yes
- id
- cfbb9f44-74e6-4af5-808e-19c91bfb747a
- date added to LUP
- 2023-12-20 13:54:10
- date last changed
- 2024-04-18 23:32:30
@article{cfbb9f44-74e6-4af5-808e-19c91bfb747a,
abstract = {{<p>Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12–17-year-olds) meeting criteria for BDD were recruited nationally to a specialist outpatient clinic in Stockholm, Sweden. One participant withdrew consent and their data could not be analysed. Nineteen participants were offered 12 modules of therapist-guided ICBT for BDD and were followed up to 12 months post-treatment. Preliminary efficacy was measured at the a priori primary endpoint (3-month follow-up) and at the 12-month follow-up with the clinician-rated Yale-Brown Obsessive Compulsive Scale Modified for BDD for Adolescents. The treatment was rated as both credible and satisfactory and was associated with a large and statistically significant reduction in BDD symptom severity (d = 2.94). The proportion of participants classified as responders at the primary endpoint was 73.7%, and the proportion of full or partial remitters was 63.2%. The average therapist support time was 8 min per participant per week. Treatment gains continued to accrue up to the 12-month follow-up. Two participants attempted suicide and another two reported non-suicidal self-injuries during the study period. ICBT with minimal therapist support is a feasible, potentially efficacious, and durable treatment for adolescents with BDD. Risky behaviours typical of this patient group should be carefully monitored during treatment.</p>}},
author = {{Rautio, Daniel and Andrén, Per and Gumpert, Martina and Jolstedt, Maral and Jassi, Amita and Krebs, Georgina and Jansson-Fröjmark, Markus and Lundgren, Tobias and Serlachius, Eva and Mataix-Cols, David and Fernández de la Cruz, Lorena}},
issn = {{2214-7829}},
keywords = {{Adolescents; Body dysmorphic disorder; Cognitive behaviour therapy; Dysmorphophobia; Evidence-based interventions; Internet-based treatment; Treatment outcomes}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Internet Interventions}},
title = {{Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder : A feasibility trial with long-term follow-up}},
url = {{http://dx.doi.org/10.1016/j.invent.2023.100688}},
doi = {{10.1016/j.invent.2023.100688}},
volume = {{34}},
year = {{2023}},
}