Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up
Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Internet Interventions |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221478292300088X |
| _version_ | 1797405467557756928 |
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| author | Daniel Rautio Per Andrén Martina Gumpert Maral Jolstedt Amita Jassi Georgina Krebs Markus Jansson-Fröjmark Tobias Lundgren Eva Serlachius David Mataix-Cols Lorena Fernández de la Cruz |
| author_facet | Daniel Rautio Per Andrén Martina Gumpert Maral Jolstedt Amita Jassi Georgina Krebs Markus Jansson-Fröjmark Tobias Lundgren Eva Serlachius David Mataix-Cols Lorena Fernández de la Cruz |
| author_sort | Daniel Rautio |
| collection | DOAJ |
| description | Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12–17-year-olds) meeting criteria for BDD were recruited nationally to a specialist outpatient clinic in Stockholm, Sweden. One participant withdrew consent and their data could not be analysed. Nineteen participants were offered 12 modules of therapist-guided ICBT for BDD and were followed up to 12 months post-treatment. Preliminary efficacy was measured at the a priori primary endpoint (3-month follow-up) and at the 12-month follow-up with the clinician-rated Yale-Brown Obsessive Compulsive Scale Modified for BDD for Adolescents. The treatment was rated as both credible and satisfactory and was associated with a large and statistically significant reduction in BDD symptom severity (d = 2.94). The proportion of participants classified as responders at the primary endpoint was 73.7%, and the proportion of full or partial remitters was 63.2%. The average therapist support time was 8 min per participant per week. Treatment gains continued to accrue up to the 12-month follow-up. Two participants attempted suicide and another two reported non-suicidal self-injuries during the study period. ICBT with minimal therapist support is a feasible, potentially efficacious, and durable treatment for adolescents with BDD. Risky behaviours typical of this patient group should be carefully monitored during treatment. |
| first_indexed | 2024-03-09T03:10:21Z |
| format | Article |
| id | doaj.art-d58495a349254de0a4f15abfaba59b65 |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-03-09T03:10:21Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-d58495a349254de0a4f15abfaba59b652023-12-04T05:22:01ZengElsevierInternet Interventions2214-78292023-12-0134100688Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-upDaniel Rautio0Per Andrén1Martina Gumpert2Maral Jolstedt3Amita Jassi4Georgina Krebs5Markus Jansson-Fröjmark6Tobias Lundgren7Eva Serlachius8David Mataix-Cols9Lorena Fernández de la Cruz10Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Corresponding author at: Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Centre, Gävlegatan 22B, floor 8, SE-113 30 Stockholm, Sweden.Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Lund University, Lund, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenNational and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, England, United KingdomNational and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, England, United Kingdom; University College London, Research Department of Clinical, Educational and Health Psychology, London, England, United KingdomCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Lund University, Lund, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Department of Clinical Sciences, Lund University, Lund, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenBody dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12–17-year-olds) meeting criteria for BDD were recruited nationally to a specialist outpatient clinic in Stockholm, Sweden. One participant withdrew consent and their data could not be analysed. Nineteen participants were offered 12 modules of therapist-guided ICBT for BDD and were followed up to 12 months post-treatment. Preliminary efficacy was measured at the a priori primary endpoint (3-month follow-up) and at the 12-month follow-up with the clinician-rated Yale-Brown Obsessive Compulsive Scale Modified for BDD for Adolescents. The treatment was rated as both credible and satisfactory and was associated with a large and statistically significant reduction in BDD symptom severity (d = 2.94). The proportion of participants classified as responders at the primary endpoint was 73.7%, and the proportion of full or partial remitters was 63.2%. The average therapist support time was 8 min per participant per week. Treatment gains continued to accrue up to the 12-month follow-up. Two participants attempted suicide and another two reported non-suicidal self-injuries during the study period. ICBT with minimal therapist support is a feasible, potentially efficacious, and durable treatment for adolescents with BDD. Risky behaviours typical of this patient group should be carefully monitored during treatment.http://www.sciencedirect.com/science/article/pii/S221478292300088XBody dysmorphic disorderDysmorphophobiaEvidence-based interventionsInternet-based treatmentCognitive behaviour therapyTreatment outcomes |
| spellingShingle | Daniel Rautio Per Andrén Martina Gumpert Maral Jolstedt Amita Jassi Georgina Krebs Markus Jansson-Fröjmark Tobias Lundgren Eva Serlachius David Mataix-Cols Lorena Fernández de la Cruz Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up Internet Interventions Body dysmorphic disorder Dysmorphophobia Evidence-based interventions Internet-based treatment Cognitive behaviour therapy Treatment outcomes |
| title | Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up |
| title_full | Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up |
| title_fullStr | Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up |
| title_full_unstemmed | Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up |
| title_short | Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up |
| title_sort | therapist guided internet delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder a feasibility trial with long term follow up |
| topic | Body dysmorphic disorder Dysmorphophobia Evidence-based interventions Internet-based treatment Cognitive behaviour therapy Treatment outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S221478292300088X |
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