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Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial

OBJECTIVES: Most patients with body dysmorphic disorder (BDD) do not receive evidence-based treatment. A randomised controlled trial (RCT) has found that a therapist-guided internet-based cognitive–behavioural therapy (CBT) programme for BDD (BDD-NET) can be delivered safely via the internet with si...

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Autores principales: Enander, Jesper, Ljótsson, Brjánn, Anderhell, Lina, Runeborg, Martin, Flygare, Oskar, Cottman, Oskar, Andersson, Erik, Dahlén, Sofia, Lichtenstein, Linn, Ivanov, Volen Z, Mataix-Cols, David, Rück, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340432/
https://www.ncbi.nlm.nih.gov/pubmed/30647044
http://dx.doi.org/10.1136/bmjopen-2018-024307
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author Enander, Jesper
Ljótsson, Brjánn
Anderhell, Lina
Runeborg, Martin
Flygare, Oskar
Cottman, Oskar
Andersson, Erik
Dahlén, Sofia
Lichtenstein, Linn
Ivanov, Volen Z
Mataix-Cols, David
Rück, Christian
author_facet Enander, Jesper
Ljótsson, Brjánn
Anderhell, Lina
Runeborg, Martin
Flygare, Oskar
Cottman, Oskar
Andersson, Erik
Dahlén, Sofia
Lichtenstein, Linn
Ivanov, Volen Z
Mataix-Cols, David
Rück, Christian
author_sort Enander, Jesper
collection PubMed
description OBJECTIVES: Most patients with body dysmorphic disorder (BDD) do not receive evidence-based treatment. A randomised controlled trial (RCT) has found that a therapist-guided internet-based cognitive–behavioural therapy (CBT) programme for BDD (BDD-NET) can be delivered safely via the internet with significant improvements in BDD symptom severity in the short term. The purpose of this study was to evaluate if the therapeutic gains of BDD-NET are maintained 2 years after treatment. SETTING: Academic medical centre. PARTICIPANTS: A naturalistic 2-year follow-up study of the 88 self-referred adult outpatients with a diagnosis of BDD that had received BDD-NET within the context of the RCT. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the BDD-Yale-Brown Obsessive-Compulsive Scale (YBOCS). Responder status was defined as a ≥30% reduction in symptoms. Remission was defined as no longer meeting Diagnostic and Statistical Manual of Mental Disorders 5th edition criteria for BDD. Secondary outcomes included measures of depression, global functioning and quality of life. RESULTS: The efficacy of BDD-NET was sustained long- term, with further improvements observed on the BDD-YBOCS during the follow-up period. At follow-up, 69% (95% CI 57% to 80%) were classified as responders and 56% (95% CI 43% to 69%) were in remission. Gains on depressive symptoms and global functioning were also sustained but not quality of life. A majority of participants reported that the main reason for seeking help for their BDD was the possibility to access the treatment from home. CONCLUSION: BDD-NET is an effective treatment for BDD, and the patients’ gains are maintained in the long term. BDD-NET has the potential to increase access to CBT and may lower the threshold for BDD sufferers to seek help in the first place. TRIAL REGISTRATION NUMBER: NCT02010619.
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spelling pubmed-63404322019-02-02 Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial Enander, Jesper Ljótsson, Brjánn Anderhell, Lina Runeborg, Martin Flygare, Oskar Cottman, Oskar Andersson, Erik Dahlén, Sofia Lichtenstein, Linn Ivanov, Volen Z Mataix-Cols, David Rück, Christian BMJ Open Mental Health OBJECTIVES: Most patients with body dysmorphic disorder (BDD) do not receive evidence-based treatment. A randomised controlled trial (RCT) has found that a therapist-guided internet-based cognitive–behavioural therapy (CBT) programme for BDD (BDD-NET) can be delivered safely via the internet with significant improvements in BDD symptom severity in the short term. The purpose of this study was to evaluate if the therapeutic gains of BDD-NET are maintained 2 years after treatment. SETTING: Academic medical centre. PARTICIPANTS: A naturalistic 2-year follow-up study of the 88 self-referred adult outpatients with a diagnosis of BDD that had received BDD-NET within the context of the RCT. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the BDD-Yale-Brown Obsessive-Compulsive Scale (YBOCS). Responder status was defined as a ≥30% reduction in symptoms. Remission was defined as no longer meeting Diagnostic and Statistical Manual of Mental Disorders 5th edition criteria for BDD. Secondary outcomes included measures of depression, global functioning and quality of life. RESULTS: The efficacy of BDD-NET was sustained long- term, with further improvements observed on the BDD-YBOCS during the follow-up period. At follow-up, 69% (95% CI 57% to 80%) were classified as responders and 56% (95% CI 43% to 69%) were in remission. Gains on depressive symptoms and global functioning were also sustained but not quality of life. A majority of participants reported that the main reason for seeking help for their BDD was the possibility to access the treatment from home. CONCLUSION: BDD-NET is an effective treatment for BDD, and the patients’ gains are maintained in the long term. BDD-NET has the potential to increase access to CBT and may lower the threshold for BDD sufferers to seek help in the first place. TRIAL REGISTRATION NUMBER: NCT02010619. BMJ Publishing Group 2019-01-15 /pmc/articles/PMC6340432/ /pubmed/30647044 http://dx.doi.org/10.1136/bmjopen-2018-024307 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Mental Health
Enander, Jesper
Ljótsson, Brjánn
Anderhell, Lina
Runeborg, Martin
Flygare, Oskar
Cottman, Oskar
Andersson, Erik
Dahlén, Sofia
Lichtenstein, Linn
Ivanov, Volen Z
Mataix-Cols, David
Rück, Christian
Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title_full Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title_fullStr Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title_full_unstemmed Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title_short Long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (BDD-NET): a naturalistic 2-year follow-up after a randomised controlled trial
title_sort long-term outcome of therapist-guided internet-based cognitive behavioural therapy for body dysmorphic disorder (bdd-net): a naturalistic 2-year follow-up after a randomised controlled trial
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340432/
https://www.ncbi.nlm.nih.gov/pubmed/30647044
http://dx.doi.org/10.1136/bmjopen-2018-024307
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