Phillips Katharine A, Menard William
Body Dysmorphic Disorder Program, Butler Hospital, Providence, RI, USA.
CNS Spectr. 2009 May;14(5):252-60. doi: 10.1017/s1092852900025414.
Body dysmorphic disorder (BDD) is an often severe disorder, but few treatment studies have been conducted.
This pilot study explored the efficacy and safety of the antiepileptic medication levetiracetam for BDD.
Seventeen subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BDD participated in a 12-week open-label levetiracetam trial. Subjects were assessed at regular intervals with standard measures.
In intent-to-treat analyses, scores on the Yale-Brown Obsessive Compulsive Scale Modified for BDD (BDD-YBOCS), the primary outcome measure, decreased from 32.5+/-4.7 at baseline to 21.5+/-11.0 at endpoint (P<.001). Approximately 60% (n=9) of subjects were responders (>30% decrease on the BDD-YBOCS). The mean time to response was 4.6+/-2.8 (range: 2-10) weeks. Scores also significantly improved on the Brown Assessment of Beliefs Scale, the Hamilton Rating Scale for Depression, the Global Assessment of Functioning Scale, and the Social and Occupational Functioning Assessment Scale. Scores did not significantly improve on the Quality of Life Enjoyment and Satisfaction Questionnaire, the Beck Anxiety Inventory, or the Social Phobia Inventory. The mean endpoint dose of levetiracetam was 2,044.1+/-1,065.2 (range: 250-3,000) mg/day, and it was relatively well-tolerated.
Randomized, double-blind placebo-controlled studies of levetiracetam for BDD are needed to confirm these preliminary findings.
躯体变形障碍(BDD)通常是一种严重的疾病,但针对其的治疗研究较少。
本试点研究探讨抗癫痫药物左乙拉西坦治疗BDD的疗效和安全性。
17名符合《精神疾病诊断与统计手册》第四版中BDD诊断标准的受试者参与了一项为期12周的左乙拉西坦开放标签试验。定期使用标准量表对受试者进行评估。
在意向性分析中,主要结局指标——针对BDD修改后的耶鲁-布朗强迫量表(BDD-YBOCS)评分从基线时的32.5±4.7降至终点时的21.5±11.0(P<0.001)。约60%(n=9)的受试者有反应(BDD-YBOCS评分下降>30%)。平均起效时间为4.6±2.8(范围:2 - 10)周。在布朗信念评估量表、汉密尔顿抑郁评定量表、总体功能评估量表以及社会和职业功能评估量表上的评分也有显著改善。在生活享受与满意度问卷、贝克焦虑量表或社交恐惧症量表上的评分没有显著改善。左乙拉西坦的平均终点剂量为2044.1±1065.2(范围:250 - 3000)mg/天,且耐受性相对良好。
需要进行关于左乙拉西坦治疗BDD的随机、双盲、安慰剂对照研究来证实这些初步发现。