Cognitive Behaviour Therapy (CBT) for Body Dysmorphic Disorder (BDD)

This study has been completed.
Information provided by (Responsible Party):
David Veale, Institute of Psychiatry, London Identifier:
First received: March 27, 2009
Last updated: September 2, 2014
Last verified: September 2014

The aim of the research is to determine if Cognitive Behaviour Therapy (CBT) specific for BDD is more effective than a credible non-specific form of CBT for treating BDD and its delusional variant in adults aged 17 or over. This will be done in a single centre randomised controlled trial that compares specific CBT for BDD versus non-specific CBT over 12 weeks. The hypotheses to be tested are that: (1) specific CBT for BDD will be more effective than non-specific CBT at 12 weeks (2) Treatment effects from Specific CBT will be maintained at 1 month, 3 months and 1 year follow up. The main study end-point is at 12 weeks and the secondary end-point is at 3 months and 1 year. A secondary aim is to explore whether delusionality (insight) as measured by the Brown Assessment of Beliefs and co-morbid depressed mood predicts response to treatment.

Condition Intervention
Body Dysmorphic Disorder
Behavioral: CBT specific for BDD
Behavioral: Non specific CBT

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Efficacy of Cognitive Behaviour Therapy -v- Anxiety Management for Body Dysmorphic Disorder: a Randomised Controlled Trial

Resource links provided by NLM:

Further study details as provided by Institute of Psychiatry, London:

Primary Outcome Measures:
  • Yale Brown Obsessive Compulsive Scale (modified for BDD) (BDD -YBOCS)(Phillips et al., 1997) [ Time Frame: baseline, 6 weeks, 12 weeks, 1 month post treatment, 3 months post treatment and 1 year post treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Brown Assessment of Beliefs to measure the strength of conviction in beliefs about being ugly (Eisen et al., 1998) [ Time Frame: baseline, 6 weeks, 12 weeks, 1 month post treatment, 3 months post treatment and 1 year post treatment ] [ Designated as safety issue: No ]
  • Montgomery Asberg Depression rating scale (Montgomery and Asberg, 1979). There are also five brief self-rated scales [ Time Frame: baseline, 6 weeks, 12 weeks, 1 month post treatment, 3 months post treatment and 1 year post treatment ] [ Designated as safety issue: No ]

Enrollment: 42
Study Start Date: April 2009
Study Completion Date: January 2014
Primary Completion Date: May 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CBT specific for BDD Behavioral: CBT specific for BDD
Cognitive behaviour therapy (CBT) which is specific for BDD. A pilot study (Veale et al, 1996b) twelve years ago has demonstrated significant benefit of CBT over a waiting list. The mean reduction was about 50% on the primary outcome measure (YBOCS for BDD). This consisted of a reduction of 12 points and a standard deviation of 7 on the YBOCS for BDD and the treatment is now thought to be better than in 1996.
Active Comparator: Non Specific CBT Behavioral: Non specific CBT
CBT which is not specific for BDD (stress management and cognitive restructuring) which has been shown to be a credible alternative psychological treatment to CBT in health anxiety. However in two pilot cases of BDD, the benefits were minimal with a reduction of between zero and 10% on the YBOCS for BDD. At the most this equates to a maximum of 3 points reduction.


Ages Eligible for Study:   17 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • BDD is the main psychological problem. We will use DSMIV criteria as BDD does not exist as a separate diagnosis in ICD10. They may have an additional diagnosis of Delusional Disorder when it refers to beliefs about being ugly or defective.
  • They must have a total of 24 or more on the twelve-item YBOCS modified for BDD (Phillips et al., 1997).
  • They may be of either gender but must be 17 years or above.
  • They are willing to travel to the treatment centre for weekly sessions.
  • They are wiling to complete regular questionnaires and be audiotaped for supervision and for listening to enhance their learning.
  • They may be taking psychotropic medication so long as it is stabilised and there are no plans to increase the dose.

Exclusion Criteria:

  • They have a current or past diagnosis of schizophrenia, bipolar affective disorder.
  • They have current suicidal intent or severe self-neglect that requires hospitalisation.
  • They have a current alcohol or substance dependence or anorexia nervosa or borderline personality disorder that requires treatment in its own right.
  • They are currently receiving any other form of psychotherapy,
  • They have received CBT for BDD in the past 6 months, which is judged as competently delivered and did not respond.
  • They cannot speak sufficient English for CBT. (Assistance will be provided for those who speak English but are unable to read questionnaires).
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Please refer to this study by its identifier: NCT00871143

United Kingdom
South London and Maudsley NHS Trust
London, United Kingdom, SE5 8AZ
Sponsors and Collaborators
Institute of Psychiatry, London
  More Information

Responsible Party: David Veale, Consultant Psychiatrist, Institute of Psychiatry, London Identifier: NCT00871143     History of Changes
Other Study ID Numbers: PAXKAYR, 0
Study First Received: March 27, 2009
Last Updated: September 2, 2014
Health Authority: United Kingdom: National Health Service

Keywords provided by Institute of Psychiatry, London:

Additional relevant MeSH terms:
Body Dysmorphic Disorders
Mental Disorders
Somatoform Disorders processed this record on August 27, 2015