Rates of remission, sustained remission, and recurrence in a randomized controlled trial of cognitive behavioral therapy versus supportive psychotherapy for body dysmorphic disorder

Hilary Weingarden; Susanne S Hoeppner; Ivar Snorrason; Jennifer L Greenberg; Katharine A Phillips; Sabine Wilhelm

doi:10.1002/da.23148

Rates of remission, sustained remission, and recurrence in a randomized controlled trial of cognitive behavioral therapy versus supportive psychotherapy for body dysmorphic disorder

Depress Anxiety. 2021 Mar 16:10.1002/da.23148. doi: 10.1002/da.23148. Online ahead of print.

Authors

Hilary Weingarden¹, Susanne S Hoeppner¹, Ivar Snorrason¹, Jennifer L Greenberg¹, Katharine A Phillips^{2

3}, Sabine Wilhelm¹

Affiliations

¹ Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, USA.
² New York-Presbyterian Hospital and Weill Cornell Medical College, New York City, New York, USA.
³ Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Abstract

Background: Little data exist on remission rates following psychotherapy for body dysmorphic disorder (BDD).

Methods: Using data from a large study of therapist-delivered cognitive behavior therapy (CBT) versus supportive psychotherapy (SPT) for BDD (N = 120), we estimated remission rates at treatment endpoint, and rates of delayed remission, sustained remission, and recurrence at 6-month follow-up. We also examined improvement in broader mental health outcomes among remitters.

Results: Full or partial remission rates at end-of-treatment were significantly higher following CBT (68%) than SPT (42%). At 6-month follow-up, an additional 10% (CBT) and 14% (SPT) experienced delayed remission, 52% (CBT) and 27% (SPT) experienced sustained remission, and 20% (CBT) and 14% (SPT) experienced recurrence. Remission was never achieved by 18% (CBT) and 45% (SPT). Participants in remission at end-of-treatment experienced significant improvements in functional impairment, depression severity, BDD-related insight, and quality of life compared to nonremitters.

Conclusions: Full or partial remission rates are high following CBT for BDD and higher than after SPT.

Keywords: body dysmorphic disorder; cognitive behavioral therapy; remission; supportive psychotherapy.

Abstract

Grants and funding