Clomipramine vs Desipramine Crossover Trial in Body Dysmorphic Disorder

Hollander, Eric; Allen, Andrea; Kwon, Jee Hyun; Aronowitz, Bonnie; Schmeidler, James; Wong, Cheryl M.; Simeon, Daphne

doi:10.1001/archpsyc.56.11.1033

Cited by 245 publications

(72 citation statements)

References 12 publications

(8 reference statements)

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“…Individuals with BDD had poor psychosocial functioning, consistent with previous studies (Hollander et al, 1999;Phillips, 2000;Phillips, 2006;Phillips & Najjar, 2003). In addition, prospectively assessed functioning remained stably poor over time.…”

Section: Discussionsupporting

confidence: 86%

“…At intake and each follow-up interview, we recorded whether the subject had received medication or therapy since the last interview. In this report, we focus on receipt of a serotonin-reuptake inhibitor (SRI) or cognitive behavioral therapy (CBT) because there is empirical evidence of their efficacy for BDD (Hollander et al, 1999;Neziroglu & Khemlani-Patel, 2002;Phillips et al, 2002). Treatment data were obtained using: 1) the reliable Psychosocial Treatment Inventory (Steketee et al, 1997), which determined subjects' perceptions of types of psychotherapy modalities (e.g., cognitive or behavioral) they received, and 2) the Longitudinal Interval Follow-Up Evaluation (LIFE), a semi-structured interview and rating system that records treatment received in longitudinal studies of mental disorders (Keller et al, 1987).…”

Section: Assessmentsmentioning

confidence: 99%

“…Subsequent studies which used standard functioning measures reported impairment in psychosocial functioning. In a BDD pharmacotherapy study (n=20), Schneier Disability Profile scores reflected moderate functional impairment (Hollander et al, 1999). In a study of 62 patients with BDD (85% of whom participated in a placebo-controlled pharmacotherapy study [Phillips et al, 2002]), scores on the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) (Ware, 1993) were markedly poor in all mental health domains.…”

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confidence: 99%

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Functional impairment in body dysmorphic disorder: A prospective, follow-up study

Phillips

Quinn

Stout

2008

Journal of Psychiatric Research

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Cross sectional/retrospective studies indicate that individuals with body dysmorphic disorder (BDD) have markedly impaired psychosocial functioning. However, no study has prospectively examined functioning in BDD. In this study, which is to our knowledge the first prospective study of the course of BDD, psychosocial functioning was assessed at baseline and over 1 to 3 years (mean = 2.7 ± 0.9 years) of follow-up with the Global Assessment of Functioning Scale (GAF), Social and Occupational Functioning Scale (SOFAS), and LIFE-RIFT (Range of Impaired Functioning Tool). Psychosocial functioning was poor during the follow-up period. Functioning remained stably poor over time on the SOFAS and LIFE-RIFT, although there was a trend for a gradual and slight improvement on the GAF over time. The cumulative probability of attaining functional remission on the GAF (score >70 for at least 2 consecutive months) during the follow-up period was only 5.7%. On the SOFAS, the cumulative probability of attaining functional remission (score >70 for at least 2 consecutive months) was 10.6%. BDD severity significantly predicted functioning on the GAF (p=.0012), SOFAS (p=.0017), and LIFE-RIFT (p=.0015). A trend for a time-by-BDD severity interaction was found on the GAF (p=.033) but not the SOFAS or LIFE-RIFT. More delusional BDD symptoms also predicted poorer functioning on all measures, although this finding was no longer significant when controlling for BDD severity. Functioning was not predicted, however, by age, gender, BDD duration, or a personality disorder. In conclusion, psychosocial functioning was poor over time, and few subjects attained functional remission. Greater BDD severity predicted poorer functioning.

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Section: Discussionsupporting

confidence: 86%

Section: Assessmentsmentioning

confidence: 99%

mentioning

confidence: 99%

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Functional impairment in body dysmorphic disorder: A prospective, follow-up study

Phillips

Quinn

Stout

2008

Journal of Psychiatric Research

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“…There is, however, never likely to be a randomisedcontrolled trial of cosmetic surgery in patients with BDD comparing, for example, cognitive--behavioural therapy (Veale et al, 1996b) or a serotonin reuptake inhibitor (Hollander et al, 1999). At best, a prospective study of patients with BDD undergoing specific cosmetic surgery operations with a long-term follow-up is required to determine efficacy in the long term and whether patients eventually become satisfied after several operations.…”

Section: Commentmentioning

confidence: 99%

Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder

Veale

2000

Psychiatr. bull.

129

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Aims and MethodLittle is known about the outcome of cosmetic surgery in patients with body dysmorphic disorder (BDD). Self-reported outcome was collected on 25 patients with BDD who at the time of psychiatric assessment had reported that they had had cosmetic surgery in the past.ResultsTwenty-five patients with BDD had a total of 46 procedures. The worst outcome was found in those who had had rhinoplasty and those with repeated operations. Mammoplasty and pinnaplasty was associated with higher degrees of satisfaction. Nine patients with BDD, either in desperation at being turned down for cosmetic surgery or because they could not afford it, had performed their own ‘DIY’ surgery in which they attempted by their own hand to alter their appearance dramatically.Clinical ImplicationsCosmetic surgery cannot at present be recommended for patients with BDD. However, patients turned down for surgery or who cannot afford it, may try to alter their appearance by themselves. The study contains a selection bias of patients in favour of treatment failures in cosmetic surgery and prospective studies are required on BDD patients who obtain cosmetic surgery or dermatological treatment.

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“…The perpendiculars were constructed from anterior-inferior corner of cranial vertebra C5 and anterior-superior corner of caudal vertebra C6 onto the bisectrix between two midplanes. Anterior disc height was defined as the sum of the perpendicular distances of these two corners to the bisectrix To detect the traction difference at a two-sided 5% significance level, if the true difference between tractions is 0.10 mm, at least 26 subjects are required in a crossover study with a power of 90% [8,11,14]. Therefore, 32 healthy adult subjects were recruited into this study (power = 0.95).…”

Section: Group Bmentioning

confidence: 99%

Comparison of the intervertebral disc spaces between axial and anterior lean cervical traction

et al. 2009

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The insufficient investigations on the changes of spinal structures during traction prevent further exploring the possible therapeutic mechanism of cervical traction. A blind randomized crossover-design study was conducted to quantitatively compare the intervertebral disc spaces between axial and anterior lean cervical traction in sitting position. A total of 96 radiographic images from the baseline measurements, axial and anterior lean tractions in 32 asymptomatic subjects were digitized for further analysis. The intra-and inter-examiner reliabilities for measuring the intervertebral disc spaces were in good ranges (ICCs = 0.928-0.942). With the application of anterior lean traction, the statistical increases were detected both in anterior and in posterior disc spaces compared to the baseline (0.29 mm and 0.24 mm; both P \ 0.01) and axial traction (0.16 mm and 0.35 mm; both P \ 0.01). The greater intervertebral disc spaces obtained during anterior lean traction might be associated with the more even distribution of traction forces over the anterior and posterior neck structures. The neck extension moment through mandible that generally occurred in the axial traction could be counteracted by the downward force of head weight during anterior lean traction. This study quantitatively demonstrated that anterior lean traction in sitting position provided more intervertebral disc space enlargements in both anterior and posterior aspects than axial traction did. These findings may serve as a therapeutic reference when cervical traction is suggested.

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Clomipramine vs Desipramine Crossover Trial in Body Dysmorphic Disorder

Abstract: Clomipramine is more effective than desipramine in the treatment of body dysmorphic disorder and is effective even among those patients who are delusional.

Cited by 245 publications

References 12 publications

Functional impairment in body dysmorphic disorder: A prospective, follow-up study

Functional impairment in body dysmorphic disorder: A prospective, follow-up study

Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder

Comparison of the intervertebral disc spaces between axial and anterior lean cervical traction

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