Study to evaluate effectiveness of cognitive behavioral therapy for BDD

Rhode Island Hospital has received a grant for more than $1.5 million from the National Institute of Mental Health (NIMH) for a 5-year study on treatment for Body Dysmorphic Disorder (BDD). Led by Katharine A. Phillips, M.D., director of the BDD Program at Rhode Island Hospital and an internationally known expert in BDD, the study will examine the effectiveness of cognitive behavioral therapy versus supportive psychotherapy for the treatment of people with BDD.

BDD is a common body image disorder that can be debilitating. Many patients who suffer from this condition receive ineffective surgical, dermatologic, or dental treatment for the slight or nonexistent defects they perceive in their appearance as a result of the disorder. To date, no adequately tested psychotherapy of any type exists for BDD.

Phillips says, "BDD is a psychiatric disorder characterized by preoccupation with nonexistent or slight defects in appearance which causes significant distress or impairment in daily functioning. People with BDD typically experience high levels of functional impairment, and many feel suicidal. Without treatment, the disorder is often chronic."

Phillips and her colleagues have developed Cognitive Behavioral Therapy (CBT) that is tailored to BDD symptoms. Phillips explains, "CBT is a very promising treatment, and it is now ready for formal testing. We will compare the effectiveness of CBT to that of supportive psychotherapy, which appears to be the kind of therapy that most people with BDD receive in the community."

"CBT offers a practical 'here and now' treatment that focuses on changing problematic BDD thoughts and behaviors, and teaching the patient practical skills that can help a person cope with and overcome BDD," explains Phillips. "Supportive psychotherapy focuses on establishing and maintaining a good relationship with the patient, supporting adaptive coping skills, improving self-esteem, and expressing emotions.

Phillips will lead the study in collaboration with Massachusetts General Hospital/Harvard Medical School; Sabine Wilhelm, Ph.D., will be the lead at that site. This study will be the first adequately controlled study of psychotherapy for BDD and will provide 22 sessions of treatment to 120 adults with BDD. The researchers will also compare the longer-term effectiveness and durability of CBT versus supportive psychotherapy in reducing BDD and other symptoms such as depression and in improving daily functioning and quality of life.