Figure 3. Secondary Symptoms and Quality of Life Over Time by Treatment.

All secondary symptoms (A-C) decreased from baseline to week 24 in supportive psychotherapy and cognitive behavioral therapy for body dysmorphic disorder (CBT-BDD) treatment arms, whereas quality of life increased (D). No treatment or site differences were found in the rate of change of lack of insight (Brown Assessment of Beliefs Scale score) and functional impairment (Sheehan Disability Scale) during treatment or follow-up. However, quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) improved more in the CBT-BDD than the supportive psychotherapy treatment arm. No treatment or site differences were found in the rate of change in depression symptoms (Beck Depression Inventory-II [Beck Depression Inventory–Second Edition]) during treatment; however, participants in the CBT-BDD arm who completed end-of-treatment assessments (week 24) were significantly less depressed than participants in the supportive psychotherapy arm. No significant changes were observed in secondary symptoms or quality of life during follow-up (weeks 24 to 50). The solid lines (estimated slopes from the growth models of change during treatment) and dashed lines (estimated slopes from the growth models of change during follow-up) shown are the model-based estimates of change over time in each treatment by site group, whereas the data points represent the raw means (SEs) of all available observations in each group at each time point. The data points based on raw data and the model-based linear trend estimates were offset from the actual week numbers in the graph to enable the visual discrimination of individual SE bars. MGH indicates Massachusetts General Hospital; RIH, Rhode Island Hospital.