We recently published an interesting overview of body dysmorphic disorder, an often misunderstood disorder where the primary symptom is an obsession with an imagined or minor defect of one’s body (for instance, spending virtually every waking moment obsessing over one’s skin, hair, or other parts of one’s body).

Body dysmorphic disorder (BDD) affects as many as one in 20 people, but its true prevalence is not known. Patients suffering from BDD worry obsessively about their physical appearance, with concerns frequently but not exclusively focused on the skin, hair and nose. People with BDD often have very low levels of self-esteem. Many people with body dysmorphic disorder are also diagnosed with depression.

The Cochrane Library recently took a look at what are considered some of the most effective treatments for body dysmorphic disorder (BDD). What they found is that there is no single effective treatment for this concern at present (or at least the research hasn’t yet been done to show that there is):

According to Cochrane Researchers, however, there is currently very little evidence regarding the relative effectiveness of drug treatment and psychotherapy approaches.

“Given the number of people suffering from BDD and the level of distress caused, it is surprising that so little data is available on treatments. This is certainly a field that deserves additional attention and funding,” said lead researcher, Jonathan Ipser, who works at the MRC Research Unit for Anxiety and Stress Disorders at the University of Stellenbosch, South Africa.

Ipser and colleagues carried out a systematic review of currently available evidence, analyzing data from four trials, which together included 169 patients. They found that over half of people treated in a single trial with the antidepressant fluoxetine for 12 weeks showed improvement, compared to less than a quarter of those given a placebo. And in two 12 week trials of cognitive behavioral therapy (CBT), symptom severity was significantly reduced. Both types of treatment were well tolerated, with no severe adverse effects reported.

With only four decent research studies done on treatments for this disorder, the evidence is not very robust. The good news is that the research done to date does show that treatment helps some people, especially with reduction of symptom severity.

More research is needed to confirm these results and perhaps find specialized CBT or other psychotherapy approaches that might be most beneficial for a person suffering from body dysmorphic disorder (BDD). In the meantime, many folks with this disorder would likely benefit to some degree from a course of psychotherapy, with the added possibility of an antidepressant prescription as well.

Reference:

Ipser JC, Sander C, Stein DJ. (2009). Pharmacotherapy and psychotherapy for body dysmorphic disorder. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD005332. DOI: 10.1002/14651858.CD005332.pub2.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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No prescription for BDD « Grey Thinking (1/21/2009)

Treatment for Body Dysmorphic Disorder - World of Psychology (1/21/2009)

    Last reviewed: By John M. Grohol, Psy.D. on 16 Jan 2009
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