Medication and psychotherapy may be beneficial for patients suffering from body dysmorphic disorder (BDD). But a new Cochrane Review found that much more research is required to determine the most effective treatment and whether both approaches should be used in combination.
Body dysmorphic disorder affects as many as one in 20 people. Patients suffering from BDD worry obsessively about their physical appearance, with concerns frequently but not exclusively focused on the skin, hair and nose, and often have very low levels of self-esteem. Many are also diagnosed with depression and around a quarter may attempt suicide. 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, analysing 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 behavioural therapy (CBT), symptom severity was significantly reduced. Both types of treatment were well tolerated, with no severe adverse effects reported.
"Both approaches seem to be acceptable to patients with this condition, as shown by low drop-out rates in trials. There was also some suggestion that psychotherapy could reduce the risk of future relapse, although we need more data on long term treatment effects to confirm this," said Ipser.