Table 1.
Cognitive or behavioral treatment of BDD: controlled trials
| References | Diagnostic criteria | Mean age and gender (%, female) | Duration of active treatment | Treatment | n | Y-BOCS-BDD scores pre → post treatment | Sig | BDDE scores pre → post treatment | Sig | Comments |
|---|---|---|---|---|---|---|---|---|---|---|
| Rosen et al36 | DSM-III-R DSM-IV |
36.5 ± 9.5 years; 100% | 8 sessions per week; 2 hours each; total 8 weeks | CBGT Waiting list |
27 27 |
NA NA |
– | 83.9 (14.8) → 41.1 (16.9) 89.9 (16.1) → 83.2 (19.7) |
P < 0.001 | CBGT significantly reduced BDD symptoms compared with the waiting list |
| Veale et al34 | DSM-IV | 35.4 ± NA years; 89.5% | 1 session per week; duration NA; total 12 weeks | CBT Waiting list |
9 10 |
22.0 (5.1) → 10.7 (9.7) 21.2 (7.2) → 24.3 (4.5) |
P < 0.01 | 72.9 (17.0) → 42.4 (25.2) 91.3 (29.7) → 95.5 (11.4) |
P < 0.01 | CBT significantly reduced BDD symptoms compared with the waiting list |
| McKay et al37 | DSM-III-R | 31.2 ± 4.7 years; 60% | 5 sessions per week; 90 minutes each; total 6 weeks | ERP + MP ERP − MP |
5 5 |
31.1 (NA) → 9.1 (NA) 30.6 (NA) → 13. 2 (NA) |
NS | NA NA |
– | ERP improved BDD symptoms, but MP did not add further benefits |
| Khemlani- Patel et al41 | DSM-IV | 32.4 ± 10.5 years; 30% | 3 sessions per week; 90 minutes each; total 8 weeks | CT + ERP ERP |
NA (10) |
27.8 (6.6) → 14.2 (6.3) 28.8 (3.7) → 18.2 (8.5) |
NS | NA NA |
– | ERP improved BDD symptoms, but CT plus ERP did not differ from ERP |
| Rabiei et al40 | DSM-IV-TR | 25.2 ± 6.5 years; 90% | 8 sessions per week; 45–60 minutes each; total 8 weeks | MCT Waiting list |
10 10 |
30.1 (6.5) → 20.1 (6.9) 30.8 (8.4) → 31.2 (8.6) |
P < 0.005 | NA NA |
– | MCT significantly reduced BDD symptoms compared with the waiting list |
Abbreviations: BDD, body dysmorphic disorder; CT, cognitive therapy; CBT, cognitive behavioral therapy; CBGT, cognitive behavioral group therapy; DSM, Diagnostic and Statistical Manual of Mental Disorders; ERP, exposure and response prevention; MP, maintenance program; MCT, metacognitive therapy; n, number of patients; NA, not available; NS, not significant; Y-BOCS-BDD, Yale-Brown Obsessive-Compulsive Scale modified for BDD; Sig, statistical significance; BDDE, Body Dysmorphic Disorder Examination.