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A Review of Cognitive and Behavioral Treatment for Body Dysmorphic Disorder

Published online by Cambridge University Press:  07 November 2014

Fugen Neziroglu  and
Sony Khemlani-Patel
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Abstract

Until recently, body dysmorphic disorder (BDD) had been vastly ignored in the scientific literature. Despite a recent surge in interest, treatment studies are still surprisingly neglected. Reports from the 1970s–1990s discuss few case descriptions and suggest anecdotal treatment strategies. Since the 1990s, information about the treatment of BDD has increased slightly. The intent of this paper is to review the current state of knowledge regarding cognitive and behavior therapy, which so far has been found to be effective. The current literature suggests that there is no difference between the efficacy of one treatment strategy over another nor the combination of cognitive and behavior therapy over behavior therapy. However, more research is needed in this area before definitive conclusions can be made.

Type
Review
Information
CNS Spectrums , Volume 7 , Issue 6 , June 2002 , pp. 464 - 471
Copyright
Copyright © Cambridge University Press 2002

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References

REFERENCES

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed [text revision]. Washington, DC: American Psychiatric Association; 2000.Google Scholar
2.Hollander, E, Cohen, LJ, Simeon, D. Body dysmorphic disorder. Psychiatr Ann. 1993;23:359–364.CrossRefGoogle Scholar
3.Hollander, E, Liebowitz, MR, Winchel, R, Klumker, A, Klein, DF. Treatment of body dysmorphic disorder with serotonin reuptake blockers. Am J Psychiatry. 1989;146:768–770.Google ScholarPubMed
4.McElroy, SL, Phillips, KA, Keck, PE. Obsessive compulsive spectrum disorders. J Clin Psychiatry. 1994;55:33–51.Google Scholar
5.Neziroglu, F, Yaryura-Tobias, JA. Body dysmorphic disorder: phenomenology and case descriptions. Behavioural Psychotherapy. 1993;21:27–36.CrossRefGoogle Scholar
6.Phillips, KA, McElroy, SL, Keck, PE, Pope, HG, Hudson, JI. Body dysmorphic disorder: 30 cases of imagined ugliness. Am J Psychiatry. 1993;150:302–308.Google ScholarPubMed
7.Yaryura-Tobias, JA, Neziroglu, F. Compulsions, aggression, and self-mutilation: a hypothalamic disorder? Journal of Orthomolecular Psychiatry. 1978;7:114–117.Google Scholar
8.Mount, R, Neziroglu, F, Taylor, CJ. An obsessive compulsive view of obesity and its treatment. J Clin Psychol. 1990;46:68–78.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
9.Neziroglu, F, Anderson, MC, Yaryura-Tobias, JA. An in-depth review of obsessive compulsive disorder, body dysmorphic disorder, hypochondriasis, and trichotillomania: therapeutic issues and current research. Crisis Intervention. 1999;5:59–94.Google Scholar
10.Phillips, KA. The Broken Mirror. New York, NY: Oxford University Press; 1996.Google Scholar
11.McKay, D, Neziroglu, F, Yaryura-Tobias, JA. Comparison of clinical characteristics in obsessive-compulsive disorder and body dysmorphic disorder. J Anxiety Disord. 1997;11:447–454.CrossRefGoogle ScholarPubMed
12.Neziroglu, F, Stevens, KP, McKay, D, Yaryura-Tobias, JA. Predictive validity of the overvalued ideas scale: Outcome in obsessive-compulsive and body dysmorphic disorders. Behav Res Ther. 2001;39:745–756.CrossRefGoogle ScholarPubMed
13.Neziroglu, F, Yaryura-Tobias, JA. A review of cognitive-behavioral and pharmacological treatment of body dysmorphic disorder. Behav Modif. 1997;21:324–330.CrossRefGoogle ScholarPubMed
14.McKenna, PJ. Disorders with overvalued ideas. Br J Psychiatry. 1984;145:579–585.CrossRefGoogle ScholarPubMed
15.Phillips, KA. Body dysmorphic disorder: the distress of imagined ugliness. Am J Psychiatry. 1991;148:1138–1149.Google ScholarPubMed
16.Phillips, KA, McElroy, SL, Keck, PE, Pope, HG, Hudson, JI. Body dysmorphic disorder: 30 cases of imagined ugliness. Am J Psychiatry. 1993;150:302–308.Google ScholarPubMed
17.Neziroglu, F, McKay, D, Todaro, J, Yaryura-Tobias, JA. Effect of cognitive behavior therapy on persons with body dysmorphic disorder and comorbid axis II diagnoses. Behav Ther. 1996;27:67–77.CrossRefGoogle Scholar
18.Brawman-Mintzer, O, Lydiard, B, Phillips, KA, et al.Body dysmorphic disorder in patients with anxiety disorders and major depression: a comorbidity study. Am J Psychiatry. 1995;152:1665–1667.Google ScholarPubMed
19.Wilhelm, S, Otto, MW, Zucker, BG, Pollack, MH. Prevalence of body dysmorphic disorder in patients with anxiety disorders. J Anxiety Disord. 1997;11:499–502.CrossRefGoogle ScholarPubMed
20.Perugi, G, Akiskal, HS, Giannotti, D, Frare, F, DiVaio, S, Cassano, GB. Gender related differences in body dysmorphic disorder (dysmorphophobia). J Nerv Ment Dis. 1997;185:578–582.CrossRefGoogle ScholarPubMed
21.Neziroglu, F, Khemlani-Patel, S, Hsia, C, Yaryura-Tobias, JA. Incidence of abuse in body dysmorphic disorder. Paper presented at the 2001 World Congress of Behavioral and Cognitive Therapies. Vancouver, British Columbia. July 17-21, 2001.Google Scholar
22.Khemlani-Patel, S. Cognitive and Behavioral Therapy for Body Dysmorphic Disorder: A Comparative Investigation [dissertation]. Hempstead, NY: Hofstra University; 2001.Google Scholar
23.Yaryura-Tobias, JA, Mancebo, MC, Neziroglu, F. Clinical and theoretical issues in self-injurious behavior. Revista Brasileira de Psiquiatria. 1999;21:178–183.CrossRefGoogle Scholar
24.Neziroglu, F, Mancebo, M. Skin picking as a form of self-injurious behavior. Psychiatr Ann. 2001;31:549–555.CrossRefGoogle Scholar
25.Phillips, KA, Taub, SL. Skin picking as a symptom of body dysmorphic disorder. Psychopharmacol Bull. 1995;31:279–288.Google ScholarPubMed
26.Wilhelm, S, Otto, MW, Lohr, B, Deckersbach, T. Cognitive behavior group therapy for body dysmorphic disorder: a case series. Behav Res Ther. 1999;37:71–75.CrossRefGoogle ScholarPubMed
27.O'Sullivan, RL, Phillips, KA, Keuthen, NJ, Wilhelm, S. Near fatal skin picking from delusional body dysmorphic disorder response to fluvoxamine. Psychosomatics. 1999;40:79–81.CrossRefGoogle ScholarPubMed
28.McElroy, SL, Phillips, KA, Keck, PE, Hudson, JI, Pope, HG. Body dysmorphic disorder: does it have a psychotic subtype? J Clin Psychiatry. 1993;54:389–395.Google ScholarPubMed
29.Phillips, KA, McElroy, SL, Keck, PE, Hudson, JI, Pope, HG. A comparison of delusional and non-delusional body dysmorphic disorder in 100 cases. Psychopharmacol Bull. 1994;30:179–186.Google Scholar
30.Veale, DM, Boocock, A, Gournay, K, et al.Body dysmorphic disorder: A survey of fifty cases. Br J Psychiatry. 1996;169:196–201.CrossRefGoogle ScholarPubMed
31.Phillips, KA. Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis. 2000;188:170–175.CrossRefGoogle ScholarPubMed
32.Rivera, RP, Borda, T. The etiology of body dysmorphic disorder. Psychiatr Ann. 2001;31:559–563.CrossRefGoogle Scholar
33.Munjack, DJ. The behavioral treatment of dysmorphophobia. J Behav Ther Exp Psychiatry. 1978;9:53–56.CrossRefGoogle Scholar
34.Braddock, LE. Dysmorphophobia in adolescence: a case report. Br J Psychiatry. 1982;140:199–201.CrossRefGoogle ScholarPubMed
35.Solyom, L, DiNicola, VF, Phil, M, Sookman, D, Luchins, D. Is there an obsessive psychosis? Aetiological and prognostic factors of an atypical form of obsessive-compulsive neurosis. Can J Psychiatry. 1985;30:372–379.CrossRefGoogle ScholarPubMed
36.Marks, I, Mishan, J. Dysmorphophobic avoidance with disturbed bodily perception: A pilot study of exposure therapy. Br J Psychiatry. 1988;152:674–678.CrossRefGoogle ScholarPubMed
37.Gomez-Perez, JC, Marks, IM, Gutierrez-Fisac, JL. Dysmorphophobia: clinical features and outcome with behavior therapy. Eur Psychiatry. 1994;9:229–235.CrossRefGoogle Scholar
38.Campisi, TA. Exposure and Response Prevention in the Treatment of Body Dysmorphic Disorder [doctoral dissertation]. Hempstead, NY: Hofstra University; 1995.Google Scholar
39.Sobanski, E, Schmidt, MH. Everybody looks at my pubic bone: a case report of an adolescent patient with body dysmorphic disorder. Acta Psychiatr Scand. 2000;101:80–82.CrossRefGoogle ScholarPubMed
40.Vitiello, B, DeLeon, J. Dysmorphophobia misdiagnosed as obsessive-compulsive disorder. Psychosomatics. 1990;31:220–222.CrossRefGoogle ScholarPubMed
41.Franklin, ME, Foa, EB. Cognitive-behavioral treatments for obsessive compulsive disorder. In: Nathan, PE, Gorman, JM, eds. A Guide to Treatments That Work. New York, NY: Oxford University Press; 1998:339–357Google Scholar
42.Abramowitz, JS. Variants of exposure and response prevention in the treatment of obsessive compulsive disorder: a meta analysis. Behav Ther. 1996;27:583–600.CrossRefGoogle Scholar
43.Abramowitz, JSEffectiveness of psychological and pharmacological treatments for obsessive compulsive disorder: a quantitative review. J Consult Clin Psychol. 1997;65:44–52.CrossRefGoogle ScholarPubMed
44.Abramowitz, JS. Does cognitive behavioral therapy cure obsessive compulsive disorder? A meta-analystic evaluation of clinical significance. 1998;29:339–355.Google Scholar
45.Yaryura-Tobias, JA, Neziroglu, F. The Obsessive Compulsive Spectrum Disorders. New York, NY: W.W. Norton & Company; 1997.Google Scholar
46.Geremia, GM, Neziroglu, F. Cognitive therapy in the treatment of body dysmorphic disorder. Clinical Psychology and Psychotherapy. 2001;8:243–251.CrossRefGoogle Scholar
47.Watts, FN. Aversion to personal body hair. A case study in the integration of behavioural and interpretative methods. Br J Med Psychol. 1990;63:335–340.CrossRefGoogle Scholar
48.Foa, EB, Steketee, G, Grayson, JB, Doppelt, HG. Treatment of obsessive-compulsives: when do we fail? In: Foa, EG, Emmelkamp, PMG, eds Failures in Behavior Therapy. New York, NY: John Wiley & Sons; 1983:10–34.Google Scholar
49.Neziroglu, F, Yaryura-Tobias, JA. Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder. Behav Ther. 1993;24:431–438.CrossRefGoogle Scholar
50.Schmidt, NB, Harrington, P. Cognitive-behavioral treatment of body dysmorphic disorder: a case report. J Behav Ther Exper Psychiatry. 1995;26:161–167.CrossRefGoogle ScholarPubMed
51.Newell, R, Shrubb, S. Attitude change and behaviour therapy in body dysmorphic disorder: two case reports. Behavioural and Cognitive Psychotherapy. 1994;22:163–169.CrossRefGoogle Scholar
52.Cromarty, P, Marks, I. Does rational role-play enhance the outcome of exposure therapy in dysmorphophobia? A case study. Br J Psychiatry. 1995;167:399–402.CrossRefGoogle ScholarPubMed
53.Neziroglu, F, Stevens, K, Yaryura-Tobias, JA. Overvalued ideas and their impact on treatment outcome. Revista Brasileira de Psiquiatria. 1999;21:209–216.CrossRefGoogle Scholar
54.Veale, D, Gournay, K, Dryden, W, et al.Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behav Res Ther. 1996;34:717–729.CrossRefGoogle ScholarPubMed
55.McKay, D, Todaro, J, Neziroglu, F, Campisi, T, Moritz, K, Yaryura-Tobias, JA. Body dysmorphic disorder: a preliminary evaluation of treatment and maintenance using exposure and response prevention. Behav Res Ther. 1997;35:67–70.CrossRefGoogle Scholar
56.McKay, D. Two year follow-up of behavioral treatment and maintenance for body dysmorphic disorder. Behav Modif. 1999;23:621–630.CrossRefGoogle ScholarPubMed
57.Butters, JW, Cash, TF. Cognitive-behavioral treatment of women's body-image dissatisfaction. Journal of Consulting and Clinical Psychology. 1987;55:889–897.CrossRefGoogle ScholarPubMed
58.Rosen, JC, Saltzberg, E, Srebnik, D. Cognitive behavior therapy for negative body image. Behavior Therapy. 1989;20:393–404.CrossRefGoogle Scholar
59.Rosen, JC, Reiter, J, Orosan, P. Cognitive-behavioral body image therapy for body dysmorphic disorder. J Consult Clin Psychol. 1995;63:263–269.CrossRefGoogle ScholarPubMed
60.Wilhelm, S, Otto, ML, Lohr, B, Deckersbach, T. Cognitive behavioral group therapy for body dysmorphic disorder: A case series. Behav Res Ther. 1999;37:71–75.CrossRefGoogle ScholarPubMed
61.Foa, EB. Failure in treating obsessive-compulsives. Behav Res Ther. 1979;17:169–176.CrossRefGoogle ScholarPubMed
62.Emmelkamp, PMG, Visser, S, Hoekstra, RJ. Cognitive therapy vs. exposure in vivo in the treatment of obsessive-compulsives. Cognit Ther Res. 1988;12:103–114.CrossRefGoogle Scholar
63.Emmelkamp, PMG, Beens, H. Cognitive therapy with obsessive-compulsive disorder: a comparative evaluation. Behav Res Ther. 1991;29:293–300.CrossRefGoogle ScholarPubMed
64.Brown, KW, McGoldrick, T, Buchanan, R. Body dysmorphic disorder: seven cases treated with eye movement desensitization and reprocessing. Behavioural and Cognitive Psychotherapy. 1997;25:203–207.CrossRefGoogle Scholar