Body dysmorphic disorder (BDD), a preoccupation with an imagined or slight defect in appearance, is a chronic, disabling, and costly disorder that is probably far more common than is recognized. This often-secret disorder causes severe distress and impaired functioning, and can lead to repeated hospitalization and suicide. Despite its recognition for more than a century, BDD has received little empirical study. In particular, there have been no controlled treatment trials of this disorder. Although neuroleptics are often used to treat BDD, recent open treatment trials suggest that BDD may respond preferentially to serotonin-reuptake inhibitors (SRIs). These preliminary studies also suggest that delusional BDD responds as well to SRIs as does nondelusional BDD. However, these findings require confirmation in a placebo-controlled trial. The proposed study compares the efficacy of fluoxetine versus placebo in a 12-week randomized double-blind trial in 96 outpatients with BDD or its delusional variant (delusional disorder, somatic type). It will assess in an exploratory manner whether treatment response is predicted by the presence and degree of delusional thinking; other predictors of treatment response will also be assessed. The study will also investigate whether BDD and its delusional disorder variant are separate disorders or the same disorder by comparing demographic and phenomenologic features, onset and course, associated psychopathology, family history, and treatment response. The proposed study will provide needed data on the treatment of a chronic, debilitating, and costly, yet understudied, disorder. It will also provide data on the question of whether BDD and its delusional variant are different disorders or the same disorder--a controversial classification issue that was debated for DSM-IV and remains to be resolved for DSM-V.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29MH054841-03
Application #
2392993
Study Section
Treatment Assessment Review Committee (TA)
Project Start
1995-04-01
Project End
2000-03-31
Budget Start
1997-04-01
Budget End
1998-03-31
Support Year
3
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Butler Hospital (Providence, RI)
Department
Type
DUNS #
069847804
City
Providence
State
RI
Country
United States
Zip Code
02906
Hart, Ashley S; Phillips, Katharine A (2013) Symmetry Concerns as a Symptom of Body Dysmorphic Disorder. J Obsessive Compuls Relat Disord 2:292-298
Phillips, Katharine A; Hart, Ashley S; Menard, William et al. (2013) Psychometric evaluation of the Brown Assessment of Beliefs Scale in body dysmorphic disorder. J Nerv Ment Dis 201:640-3
Phillips, Katharine A (2010) Pharmacotherapy for Body Dysmorphic Disorder. Psychiatr Ann 40:325-332
Phillips, Katharine A; Kelly, Megan M (2009) Suicidality in a placebo-controlled fluoxetine study of body dysmorphic disorder. Int Clin Psychopharmacol 24:26-8
Phillips, Katharine A; Rasmussen, Steven A (2004) Change in psychosocial functioning and quality of life of patients with body dysmorphic disorder treated with fluoxetine: a placebo-controlled study. Psychosomatics 45:438-44
Eisen, Jane L; Phillips, Katharine A; Coles, Meredith E et al. (2004) Insight in obsessive compulsive disorder and body dysmorphic disorder. Compr Psychiatry 45:10-5
Rauch, Scott L; Phillips, Katharine A; Segal, Ethan et al. (2003) A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Res 122:13-9
Phillips, Katharine A; Albertini, Ralph S; Rasmussen, Steven A (2002) A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Arch Gen Psychiatry 59:381-8
Phillips, K A; Grant, J; Siniscalchi, J et al. (2001) Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder. Psychosomatics 42:504-10
Phillips, K A (2000) Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis 188:170-5

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