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文拉法辛治疗躯体变形障碍的开放标签试验。

An open-label trial of venlafaxine in body dysmorphic disorder.

作者信息

Allen Andrea, Hadley Sallie Jo, Kaplan Alicia, Simeon Daphne, Friedberg Jennifer, Priday Lauren, Baker Bryann R, Greenberg Jennifer L, Hollander Eric

机构信息

Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA.

出版信息

CNS Spectr. 2008 Feb;13(2):138-44. doi: 10.1017/s1092852900016291.

Abstract

OBJECTIVE

Body dysmorphic disorder (BDD), a preoccupation with imagined ugliness, is a disabling condition that seems to respond preferentially to selective serotonin reuptake inhibitors. This open-label trial examines venlafaxine's efficacy in BDD and is the first known study of this serotonin-norepinephrine reuptake inhibitor in BDD.

METHODS

A total of 17 BDD patients 16-65 years of age entered and 11 completed a 12-16 week open-label trial of venlafaxine. Participants were treated with venlafaxine until a therapeutic dose (minimum of 150 mg/day) was reached and then maintained at that dose for 8 weeks. Key outcome measures were the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder and Clinical Global Impressions-Improvement scale.

RESULTS

Venlafaxine was found to be effective in lessening the specific symptoms and global severity of BDD. Paired t-tests were used to compare baseline and final ratings on the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder total, obsessions, and compulsions scores; by this measure venlafaxine significantly reduced BDD symptoms overall (P=.012), as well as obsessions (P=.034) and compulsions specifically (P=.021). A single sample t-test, comparing final Clinical Global Impressions-Improvement scale ratings to "no change" (score: 4) found significant improvement following treatment.

CONCLUSION

Venlafaxine may be an effective treatment for BDD, including both obsessive and compulsive symptoms. Controlled research on venlafaxine in BDD is recommended.

摘要

目的

躯体变形障碍(BDD),一种对想象中的丑陋过度关注的疾病,是一种致残性疾病,似乎对选择性5-羟色胺再摄取抑制剂有优先反应。这项开放性试验研究了文拉法辛对BDD的疗效,这是已知的关于这种5-羟色胺-去甲肾上腺素再摄取抑制剂治疗BDD的第一项研究。

方法

共有17名年龄在16至65岁之间的BDD患者进入研究,11名患者完成了为期12至16周的文拉法辛开放性试验。参与者接受文拉法辛治疗,直到达到治疗剂量(至少150毫克/天),然后维持该剂量8周。关键的结局指标是针对躯体变形障碍修改后的耶鲁-布朗强迫症量表和临床总体印象-改善量表。

结果

发现文拉法辛在减轻BDD的特定症状和总体严重程度方面有效。采用配对t检验比较针对躯体变形障碍修改后的耶鲁-布朗强迫症量表总分、强迫观念和强迫行为得分的基线和最终评分;通过该测量方法,文拉法辛总体上显著减轻了BDD症状(P = 0.012),以及强迫观念(P = 0.034)和特定的强迫行为(P = 0.021)。将最终的临床总体印象-改善量表评分与“无变化”(评分:4)进行单样本t检验,发现治疗后有显著改善。

结论

文拉法辛可能是治疗BDD的有效药物,包括强迫观念和强迫行为症状。建议对文拉法辛治疗BDD进行对照研究。

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