Practitioner Review: Assessment and treatment of body dysmorphic disorder in young people.

Body dysmorphic disorder adolescents assessment children cognitive behaviour therapy treatment

Journal

Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361

Informations de publication

Date de publication:
08 May 2024
Historique:
accepted: 16 02 2024
medline: 9 5 2024
pubmed: 9 5 2024
entrez: 8 5 2024
Statut: aheadofprint

Résumé

Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under-recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long-term consequences and treatment.

Identifiants

pubmed: 38719455
doi: 10.1111/jcpp.13984
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom

Informations de copyright

© 2024 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Références

Ahmadpanah, M., Arji, M., Arji, J., Haghighi, M., Jahangard, L., Sadeghi Bahmani, D., & Brand, S. (2019). Sociocultural attitudes towards appearance, self‐esteem and symptoms of body‐dysmorphic disorders among young adults. International Journal of Environmental Research and Public Health, 16, 4236.
Albertini, R.S., & Phillips, K.A. (1999). Thirty‐three cases of body dysmorphic disorder in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 453–459.
Alsaidan, M.S., Altayar, N.S., Alshmmari, S.H., Alshammari, M.M., Alqahtani, F.T., & Mohajer, K.A. (2020). The prevalence and determinants of body dysmorphic disorder among young social media users: A cross‐sectional study. Dermatology Reports, 12, 8774.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edn). Washington, DC: American Psychiatric Publishing.
Angelakis, I., Gooding, P.A., & Panagioti, M. (2016). Suicidality in body dysmorphic disorder (BDD): A systematic review with meta‐analysis. Clinical Psychology Review, 49, 55–66.
Bjornsson, A.S., Didie, E.R., Grant, J.E., Menard, W., Stalker, E., & Phillips, K.A. (2013). Age at onset and clinical correlates in body dysmorphic disorder. Comprehensive Psychiatry, 54, 893–903.
Bowyer, L., Krebs, G., Mataix‐Cols, D., Veale, D., & Monzani, B. (2016). A critical review of cosmetic treatment outcomes in body dysmorphic disorder. Body Image, 19, 1–8.
Buckley, V., Krebs, G., Bowyer, L., Jassi, A., Goodman, R., Clark, B., & Stringaris, A. (2018). Innovations in practice: Body dysmorphic disorder in youth–using the development and well‐being assessment as a tool to improve detection in routine clinical practice. Child and Adolescent Mental Health, 23, 291–294.
Dyl, J., Kittler, J., Phillips, K.A., & Hunt, J.I. (2006). Body dysmorphic disorder and other clinically significant body image concerns in adolescent psychiatric inpatients: Prevalence and clinical characteristics. Child Psychiatry and Human Development, 36, 369–382.
Enander, J., Andersson, E., Mataix‐Cols, D., Lichtenstein, L., Alström, K., Andersson, G., … & Rück, C. (2016). Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: Single blind randomised controlled trial. British Medical Journal, 352, i241.
Enander, J., Ivanov, V.Z., Mataix‐Cols, D., Kuja‐Halkola, R., Ljótsson, B., Lundström, S., … & Rück, C. (2018). Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: A population‐based nationwide twin study. Psychological Medicine, 48, 2740–2747.
Faravelli, C., Salvatori, S., Galassi, F., Aiazzi, L., Drei, C., & Cabras, P. (1997). Epidemiology of somatoform disorders: A community survey in Florence. Social Psychiatry and Psychiatric Epidemiology, 32, 24–29.
Flygare, O., Andersson, E., Glimsdal, G., Mataix‐Cols, D., Pascal, D., Rück, C., & Enander, J. (2023). Cost‐effectiveness of internet‐delivered cognitive behaviour therapy for body dysmorphic disorder: Results from a randomised controlled trial. Internet Interventions, 31, 100604.
Grant, J.E., Kim, S.W., & Crow, S.J. (2001). Prevalence and clinical features of body dysmorphic disorder in adolescent and adult psychiatric inpatients. The Journal of Clinical Psychiatry, 62, 517–522.
Greenberg, J.L., Mothi, S.S., & Wilhelm, S. (2016). Cognitive‐behavioral therapy for adolescent body dysmorphic disorder: A pilot study. Behavior Therapy, 47, 213–224.
Gupta, M., Jassi, A., & Krebs, G. (2023). The association between social media use and body dysmorphic symptoms in young people. Frontiers in Psychology, 14, 1231801.
Harrison, A., Fernández de la Cruz, L., Enander, J., Radua, J., & Mataix‐Cols, D. (2016). Cognitive‐behavioral therapy for body dysmorphic disorder: A systematic review and meta‐analysis of randomized controlled trials. Clinical Psychology Review, 48, 43–51.
Hartmann, A.S., Schmidt, M., Staufenbiel, T., Ebert, D.D., Martin, A., & Schoenenberg, K. (2021). ImaginYouth—A therapist‐guided internet‐based cognitive‐behavioral program for adolescents and young adults with body dysmorphic disorder: Study protocol for a two‐arm randomized controlled trial. Frontiers in Psychiatry, 12, 682965.
Hoeppner, S.S., Hall, M.D., Hiranandani, M., Greenberg, J.L., Wilhelm, S., & Phillips, K.A. (2023). Time to response in therapy for body dysmorphic disorder: A comparison of cognitive behavioral therapy and supportive psychotherapy. Behavior Therapy, 55, 68–79.
Hollander, E., Allen, A., Kwon, J., Aronowitz, B., Schmeidler, J., Wong, C., & Simeon, D. (1999). Clomipramine vs desipramine crossover trial in body dysmorphic disorder: Selective efficacy of a serotonin reuptake inhibitor in imagined ugliness. Archives of General Psychiatry, 56, 1033–1039.
Jassi, A.D., Baloch, A., Thomas‐Smith, K., & Lewis, A. (2020). Family accommodation in pediatric body dysmorphic disorder: A qualitative study. Bulletin of the Menninger Clinic, 84, 319–336.
Knafo, A., & Jaffee, S.R. (2013). Gene–environment correlation in developmental psychopathology. Development and Psychopathology, 25, 1–6.
Krebs, G., Clark, B., Ford, T., & Stringaris, A. (in press). Epidemiology of body dysmorphic disorder the youth: Prevalence, comorbidity and psychosocial impact. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2024.01.017
Krebs, G., Fernández de la Cruz, L., & Mataix‐Cols, D. (2017). Recent advances in understanding and managing body dysmorphic disorder. BMJ Mental Health, 20, 71–75.
Krebs, G., Fernández de la Cruz, L., Monzani, B., Bowyer, L., Anson, M., Cadman, J., … & Mataix‐Cols, D. (2017). Long‐term outcomes of cognitive‐behavioral therapy for adolescent body dysmorphic disorder. Behavior Therapy, 48, 462–473.
Krebs, G., Fernández de la Cruz, L., Rijsdijk, F.V., Rautio, D., Enander, J., Rück, C., … & Eley, T.C. (2022). The association between body dysmorphic symptoms and suicidality among adolescents and young adults: A genetically informative study. Psychological Medicine, 52, 1268–1276.
Krebs, G., Rifkin‐Zybutz, R., Clark, B., & Jassi, A. (2023). Access to evidence‐based treatments for young people with body dysmorphic disorder. Archives of Disease in Childhood, 108, 684–685.
Kuck, N., Dietel, F.A., Nohr, L., Vahrenhold, J., & Buhlmann, U. (2022). A smartphone app for the prevention and early intervention of body dysmorphic disorder: Development and evaluation of the content, usability, and aesthetics. Internet Interventions, 28, 100521.
Longobardi, C., Badenes‐Ribera, L., & Fabris, M.A. (2022). Adverse childhood experiences and body dysmorphic symptoms: A meta‐analysis. Body Image, 40, 267–284.
Lopez‐Sola, C., Fontenelle, L.F., Bui, M., Hopper, J.L., Pantelis, C., Yücel, M., … & Harrison, B.J. (2016). Aetiological overlap between obsessive–compulsive related and anxiety disorder symptoms: Multivariate twin study. The British Journal of Psychiatry, 208, 26–33.
Marques, L., Weingarden, H.M., LeBlanc, N.J., & Wilhelm, S. (2011). Treatment utilization and barriers to treatment engagement among people with body dysmorphic symptoms. Journal of Psychosomatic Research, 70, 286–293.
Mataix‐Cols, D., Fernández de la Cruz, L., Isomura, K., Anson, M., Turner, C., Monzani, B., … & Krebs, G. (2015). A pilot randomized controlled trial of cognitive‐behavioral therapy for adolescents with body dysmorphic disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 895–904.
Mayville, S., Katz, R.C., Gipson, M.T., & Cabral, K. (1999). Assessing the prevalence of body dysmorphic disorder in an ethnically diverse group of adolescents. Journal of Child and Family Studies, 8, 357–362.
Möllmann, A., Dietel, F.A., Hunger, A., & Buhlmann, U. (2017). Prevalence of body dysmorphic disorder and associated features in German adolescents: A self‐report survey. Psychiatry Research, 254, 263–267.
Monzani, B., Fallah, D., Rautio, D., Gumpert, M., Jassi, A., Fernandez de la Cruz, L., … & Krebs, G. (2022). Psychometric evaluation of the Yale‐Brown obsessive‐compulsive scale modified for body dysmorphic disorder for adolescents (BDD‐YBOCS‐A). Child Psychiatry & Human Development, 54, 1799–1806.
Monzani, B., Rijsdijk, F., Harris, J., & Mataix‐Cols, D. (2014). The structure of genetic and environmental risk factors for dimensional representations of DSM‐5 obsessive‐compulsive spectrum disorders. JAMA Psychiatry, 71, 182–189.
NICE. (2005). Obsessive‐compulsive disorder: Core interventions in the treatment of obsessive‐compulsive disorder and body dysmorphic disorder. London: National Institute for Health and Clinical Excellence.
Phillips, K.A. (2005). Placebo‐controlled study of Pimozide augmentation of fluoxetine in body dysmorphic disorder. American Journal of Psychiatry, 162, 377–379.
Phillips, K.A., Albertini, R.S., & Rasmussen, S.A. (2002). A randomized placebo‐controlled trial of fluoxetine in body dysmorphic disorder. Archives of General Psychiatry, 59, 381–388.
Phillips, K.A., Didie, E.R., Menard, W., Pagano, M.E., Fay, C., & Weisberg, R.B. (2006). Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Research, 141, 305–314.
Phillips, K.A., Hart, A.S., & Menard, W. (2014). Psychometric evaluation of the Yale–Brown Obsessive‐Compulsive Scale Modified for Body Dysmorphic Disorder (BDD‐YBOCS). Journal of Obsessive‐Compulsive and Related Disorders, 3, 205–208.
Phillips, K.A., Keshaviah, A., Dougherty, D.D., Stout, R.L., Menard, W., & Wilhelm, S. (2016). Pharmacotherapy relapse prevention in body dysmorphic disorder: A double‐blind, placebo‐controlled trial. The American Journal of Psychiatry, 173, 887–895.
Phillips, K.A., & Stein, D.J. (Eds.). (2015). Handbook on obsessive compulsive and related disorders. Washington, DC: American Psychiatric Association.
Rautio, D., Gumpert, M., Jassi, A., Krebs, G., Flygare, O., Andrén, P., … & Lundgren, T. (2022). Effectiveness of multimodal treatment for young people with body dysmorphic disorder in two specialist clinics. Behavior Therapy, 53, 1037–1049.
Rautio, D., Jassi, A., Krebs, G., Andrén, P., Monzani, B., Gumpert, M., … & Jansson‐Fröjmark, M. (2022). Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. European Child & Adolescent Psychiatry, 31, 133–144.
Ritter, V., Schüller, J., Berkmann, E.M., von Soosten‐Höllings‐Lilge, L., & Stangier, U. (2023). Efficacy of cognitive therapy for body dysmorphic disorder: A randomized controlled pilot trial. Behavior Therapy, 54, 65–76.
Roberts, C., Zimmer‐Gembeck, M.J., & Farrell, L.J. (2019). The multidimensional youth body dysmorphic inventory: Development and preliminary validation. Child Psychiatry & Human Development, 50, 927–939.
Roberts, C., Zimmer‐Gembeck, M.J., Lavell, C., Miyamoto, T., Gregertsen, E., & Farrell, L.J. (2018). The appearance anxiety inventory: Factor structure and associations with appearance‐based rejection sensitivity and social anxiety. Journal of Obsessive‐Compulsive and Related Disorders, 19, 124–130.
Ryding, F.C., & Kuss, D.J. (2020). The use of social networking sites, body image dissatisfaction, and body dysmorphic disorder: A systematic review of psychological research. Psychology of Popular Media, 9, 412–435.
Schieber, K., Kollei, I., de Zwaan, M., & Martin, A. (2015). Classification of body dysmorphic disorder—What is the advantage of the new DSM‐5 criteria? Journal of Psychosomatic Research, 78, 223–227.
Schneider, S.C., Baillie, A.J., Mond, J., Turner, C.M., & Hudson, J.L. (2018). Measurement invariance of a body dysmorphic disorder symptom questionnaire across sex: The body image questionnaire–child and adolescent version. Assessment, 25, 1026–1035.
Schneider, S.C., Turner, C.M., Mond, J., & Hudson, J.L. (2016). Prevalence and correlates of body dysmorphic disorder in a community sample of adolescents. Australian and New Zealand Journal of Psychiatry, 51, 595–603.
Schulte, J., Dietel, F.A., Wilhelm, S., Nestler, S., & Buhlmann, U. (2021). Temporal dynamics of insight in body dysmorphic disorder: An ecological momentary assessment study. Journal of Abnormal Psychology, 130, 365–376.
Veale, D. (2000). Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder. Psychiatric Bulletin, 24, 218–221.
Veale, D., Anson, M., Miles, S., Pieta, M., Costa, A., & Ellison, N. (2014). Efficacy of cognitive behaviour therapy versus anxiety management for body dysmorphic disorder: A randomised controlled trial. Psychotherapy and Psychosomatics, 83, 341–353.
Veale, D., Gledhill, L.J., Christodoulou, P., & Hodsoll, J. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image, 18, 168–186.
Wilhelm, S., Phillips, K.A., Greenberg, J.L., O'Keefe, S.M., Hoeppner, S.S., Keshaviah, A., … & Schoenfeld, D.A. (2019). Efficacy and posttreatment effects of therapist‐delivered cognitive behavioral therapy vs supportive psychotherapy for adults with body dysmorphic disorder: A randomized clinical trial. JAMA Psychiatry, 76, 363–373.
Wilhelm, S., Weingarden, H., Greenberg, J.L., Hoeppner, S.S., Snorrason, I., Bernstein, E.E., … & Harrison, O.T. (2022). Efficacy of app‐based cognitive behavioral therapy for body dysmorphic disorder with coach support: Initial randomized controlled clinical trial. Psychotherapy and Psychosomatics, 91, 277–285.

Auteurs

Georgina Krebs (G)

Anxiety, self-Image and Mood (AIM) Laboratory, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
National Specialist OCD, BDD and Related Disorders Clinic for Young People, Pears Maudsley Centre, South London and Maudsley NHS Foundation Trust, London, UK.

Daniel Rautio (D)

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.

Lorena Fernández de la Cruz (L)

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.

Andrea S Hartmann (AS)

Division of Clinical Psychology and Psychotherapy of Childhood and Adolescence, Faculty of Psychology, University of Konstanz, Konstanz, Germany.

Amita Jassi (A)

National Specialist OCD, BDD and Related Disorders Clinic for Young People, Pears Maudsley Centre, South London and Maudsley NHS Foundation Trust, London, UK.

Alexandra Martin (A)

Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany.

Argyris Stringaris (A)

Anxiety, self-Image and Mood (AIM) Laboratory, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Division of Psychiatry, University College London, London, UK.
First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.

David Mataix-Cols (D)

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.
Department of Clinical Sciences, Lund University, Lund, Sweden.

Classifications MeSH