Massachusetts General Hospital/Harvard Medical School.
Massachusetts General Hospital/Harvard Medical School.
Behav Ther. 2020 Jan;51(1):15-26. doi: 10.1016/j.beth.2019.03.007. Epub 2019 Aug 7.
Body dysmorphic disorder (BDD) has a severe presentation and chronic course when untreated. Although effective BDD treatments exist, most individuals do not have access to them. We therefore developed and pilot tested the first smartphone-delivered individual cognitive-behavioral therapy (CBT) treatment for adults with BDD. The digital service was developed via user-centered design, integrating input from engineering, design, and psychology experts, plus BDD patient consultants. We conducted a 12-week open pilot trial (N = 10) to describe preliminary results for feasibility, acceptability, and treatment outcome. Attrition rates (0%) and feedback on usability and satisfaction indicated that smartphone-based CBT for BDD may be feasible, acceptable, and satisfactory. Initial results suggest that smartphone-based CBT for BDD may hold promise for improving BDD symptom severity, BDD-related insight, functional impairment, and quality of life, as scores from baseline to posttreatment improved with large-to-very large effects; depression improved with a medium effect. Ninety percent of participants were responders at posttreatment and 3-month follow-up. Smartphone-based CBT for BDD may have strong potential as a standardized, low cost, and accessible treatment for this debilitating illness. A test of efficacy is merited as a next step, using a well-powered, randomized control trial design.
躯体变形障碍（BDD）未经治疗时表现严重且病程慢性。尽管存在有效的 BDD 治疗方法，但大多数人无法获得这些治疗方法。因此，我们开发并试点测试了首款针对 BDD 成年患者的智能手机个体认知行为疗法（CBT）治疗方法。该数字服务通过以用户为中心的设计开发，整合了工程、设计和心理学专家以及 BDD 患者顾问的意见。我们进行了为期 12 周的开放试点试验（N=10），以描述可行性、可接受性和治疗结果的初步结果。零辍学率（0%）和对可用性和满意度的反馈表明，基于智能手机的 BDD CBT 可能具有可行性、可接受性和满意度。初步结果表明，基于智能手机的 BDD CBT 可能有望改善 BDD 症状严重程度、BDD 相关洞察力、功能障碍和生活质量，因为从基线到治疗后的评分均有显著改善，且效果从大到非常大；抑郁症状的改善效果为中等。90%的参与者在治疗后和 3 个月随访时为应答者。基于智能手机的 BDD CBT 作为一种标准化、低成本且易于获得的治疗方法，对于这种使人衰弱的疾病可能具有很大的潜力。下一步值得进行疗效测试，采用有力的随机对照试验设计。
