South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, Denmark Hill, London SE5 8AZ, UK.
Behav Cogn Psychother. 2012 Jul;40(4):452-61. doi: 10.1017/S1352465812000100. Epub 2012 Apr 12.
Body dysmorphic disorder (BDD) is relatively common in adolescents and can have serious negative consequences. However, the treatment of BDD in young people has received virtually no empirical attention to date, and the evidence-base for cognitive behaviour therapy (CBT) in this population is limited to a small number of single case reports.
This study aimed to investigate treatment outcomes associated with CBT, primarily consisting of exposure and response prevention, in a group of young people with BDD.
Six adolescents with a diagnosis of BDD received a course of developmentally appropriate CBT for BDD with parental involvement. BDD and depressive symptoms were evaluated at pre-treatment, post-treatment and at 3- or 6-month follow-up, using the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) and the Beck Depression Inventory-Youth, respectively.
Scores on the BDD-YBOCS indicated a 44% improvement in BDD symptoms at post-treatment and a 57% improvement at follow-up for the group. Considering response as a ≥ 30% reduction in BDD-YBOCS score, four of the six adolescents were classified as treatment responders. Improvements in depressive symptoms were observed among the treatment responders, but not the non-responders.
These findings indicate the potential efficacy of CBT, including exposure and response prevention for adolescents with BDD, and highlight the need for further controlled trials.
躯体变形障碍（BDD）在青少年中较为常见，可产生严重的负面影响。然而，迄今为止，针对青少年 BDD 的治疗几乎没有得到任何实证关注，且该人群中认知行为疗法（CBT）的证据基础仅限于少数个案报告。
本研究旨在调查 CBT 治疗 BDD 的效果，该治疗方法主要包括暴露和反应预防。
6 名被诊断患有 BDD 的青少年接受了包含父母参与的 CBT 治疗。使用 BDD-YBOCS 和贝克抑郁自评量表青少年版（BDD-YBOCS 和贝克抑郁自评量表青少年版），分别在治疗前、治疗后和 3 或 6 个月随访时评估 BDD 和抑郁症状。
BDD-YBOCS 评分显示，该组 BDD 症状在治疗后改善了 44%，随访时改善了 57%。考虑到 BDD-YBOCS 评分降低≥30%为治疗反应，6 名青少年中有 4 名被归类为治疗反应者。治疗反应者的抑郁症状有所改善，但非反应者没有。
这些发现表明，包括暴露和反应预防在内的 CBT 对青少年 BDD 具有潜在疗效，强调了需要进一步进行对照试验。
