Therapy and drugs prove to be effective against body dysmorphia

By Will Parker on January 21, 2009 in News

A new meta-study has found that drug therapy and psychotherapy can effectively treat the condition known as body dysmorphic disorder, where sufferers obsess over exaggerated or imaginary physical defects. Moreover, treatment can bring be long-lasting relief, according to the South African research team.

Body dysmorphia sufferers often pursue plastic surgery to change the perceived defect. Since the condition is primarily psychological, such procedures rarely help and often lead to symptoms growing worse. In 1997, body dysmorphic disorder received formal recognition as a mental disorder in the US.

“The key finding that treatment effects were maintained over a 4.5 month follow-up [period] after 12 weeks of cognitive behavioral psychotherapy indicates that such therapy may be effective in preventing remission over the longer term,” said lead reviewer Jonathan Ipser, from the University of Stellenbosch. For the review, the investigators analyzed five past studies: two drug studies and three psychotherapy studies.

Results from single study of fluoxetine (Prozac) versus placebo showed that Prozac-treated subjects had three times the effective clinical response compared to placebo-treated subjects. In the other included drug study, symptom severity declined significantly with clomipramine (Anafranil) treatment compared to desipramine (Norpramin); both are older tricyclic antidepressants.

In two of the three psychotherapy studies, researchers compared 12 weeks of cognitive behavioral therapy to a non-treated comparison group. Both studies reported significant improvements in symptoms among treated patients. In one of these studies, a follow-up examination at 4.5 months after treatment showed recovery from disorder symptoms in 20 of the 26 participants.

The third psychotherapy study looked at the effect of six months of maintenance psychotherapy following a six-week course of behavioral therapy. While overall ongoing symptoms did not differ between those who had or had not received maintenance therapy, significant reductions in anxiety and depression occurred among people in maintenance treatment.

“This review reinforces the value of psychotherapy, along with medications, in treating people with psychiatric disorders,” said Eric Plakun, M.D., an American Psychiatric Association spokesperson. “People are not just receptor sites for molecules and can make significant and enduring changes through therapy alone or in combination with medications.”

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