BODY DYSMORPHIC DISORDER - A COGNITIVE-BEHAVIORAL MODEL AND PILOT RANDOMIZED CONTROLLED TRIAL

A cognitive behavioural model of body image is presented with specific reference to body dysmorphic disorder (BDD). We make specific hypothe ses from the model for testing BDD patients in comparison with: (i) pa tients with ''real'' disfigurements who seek cosmetic surgery; (ii) su bjects with ''real'' disfigurements who are emotionally well adjusted; and (iii) healthy controls without any defect. There have been no ran domised controlled trials of treatment for BDD and therefore the model has clear implications for the development of cognitive behavioural t herapy. This was evaluated in a pilot controlled trial. Nineteen patie nts were randomly allocated to either cognitive behaviour therapy or a waiting list control group over 12 weeks. There were no significant p re-post differences on any of the measures in the waiting list group. There were significant changes in the treated group on specific measur es of BDD and depressed mood. Cognitive behaviour therapy should be fu rther evaluated in a larger controlled trial in comparison with anothe r psychological treatment such as interpersonal therapy and pharmacoth erapy. Copyright (C) 1996 Elsevier Science Ltd