Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia)

Perugi, Giulio; Giannotti, Daniele; Vaio, S. Di; Frare, Franco; Saettoni, Marco; Cassano, Gb

doi:10.1097/00004850-199612000-00006

Cited by 100 publications

(54 citation statements)

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“…There are also preliminary findings that the serotonin agonist mCPP but not placebo causes exacerbation of preoccupations with perceived bodily defects in patients with BDD (Hollander & Wong, 1995). Other indirect evidence comes from several open and controlled treatment studies that demonstrated that high-dose SRIs (Perugi et al, 1996;Phillips, Albertini, & Rasmussen, 2002;Phillips, Dwight, & McElroy, 1998;Phillips & Najjar, 2003) but not desipramine (Hollander et al, 1999), a primarily noradrenergic medication, are effective for treating BDD. However, perturbations of the serotonergic system that exacerbate or alleviate BDD symptoms do not prove that abnormalities of the serotonergic system necessarily underlie the pathophysiology of BDD.…”

Section: Neurochemistry Of Bddmentioning

confidence: 99%

The pathophysiology of body dysmorphic disorder

2008

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Body dysmorphic disorder (BDD) is an often severe and disabling condition, affecting up to 2% of the population. Despite its prevalence and clinical significance, very little is known about the pathophysiology of BDD. However, clues to its possible neurobiological substrates and abnormalities in information processing are starting to emerge. This article reviews findings from genetic, brain lesion, neuroimaging, neuropsychological, and psychopharmacological studies that have allowed us to develop a tentative model of the functional neuroanatomy of BDD. There is likely a complex interplay of dysfunctions in several brain networks underlying the pathophysiology of BDD. A combination of dysfunctions in frontal-subcortical circuits, temporal, parietal, and limbic structures, and possibly involving hemispheric imbalances in information processing, may produce both the characteristic symptoms and neurocognitive deficits seen in BDD. An improved understanding of the pathophysiology of BDD will be crucial to guide the development of better treatments.

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Section: Neurochemistry Of Bddmentioning

confidence: 99%

The pathophysiology of body dysmorphic disorder

2008

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“…The results of one RCT comparing clomipramine and desipramine (Hollander et al, 1999) and two case series studying fluvoxamine (Perugi et al, 1996;Phillips et al, 1998) favour SSRIs for treating BDD. Patients with delusions respond as favourably as those without (Phillips et al, 1998).…”

Section: Pharmacotherapymentioning

confidence: 99%

Cognitive–behavioural therapy for body dysmorphic disorder

Veale¹

2001

Adv. psychiatr. treat

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The DSM–IV classification of body dysmorphic disorder (BDD) refers to an individual's preoccupation with an ‘imagined’ defect in his or her appearance or markedly excessive concern with a slight physical anomaly (American Psychiatric Association, 1994). An Italian psychiatrist, Morselli, first used the term ‘dysmorphophobia’ in 1886, although it is now falling into disuse, probably because ICD–10 (World Health Organization, 1992) has discarded it, subsuming the condition under hypochondriacal disorder.

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“…In a small open-label BDD fluvoxamine study (n = 12) by Perugi and colleagues, on the self-report Hopkins Symptom Checklist-90, subjects reported that they were distressed by depression "moderately" to "quite a bit" and by anxiety "a little bit" to "moderately" (10). BDD patients also have elevated levels of perceived stress, with scores that are notably higher than those in a large national probability sample and in most normal, medical, and psychiatric samples (11).…”

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confidence: 99%

Depression, Anxiety, Anger, and Somatic Symptoms in Patients with Body Dysmorphic Disorder

Phillips¹,

Siniscalchi²,

McElroy³

2004

Psychiatr Q

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Body dysmorphic disorder (BDD) is a relatively common and impairing disorder. However, little is known about non-BDD symptoms and well-being in patients with this disorder. Seventy-five outpatients with DSM-IV BDD completed the Symptom Questionnaire, a validated self-report measure with four scales: depression, anxiety, somatic/somatization, and anger-hostility. Scores were compared to published norms for normal subjects and psychiatric outpatients. Participants in an openlabel fluvoxamine trial completed the Symptom Questionnaire at baseline and endpoint. Compared to normal controls, BDD subjects had markedly elevated scores on all four scales, indicating severe distress and psychopathology. Compared to psychiatric patients, BDD subjects had higher scores on the depression, anxiety, and anger/hostility scales but not on the somatic/somatization scale. Scores on all scales significantly decreased with fluvoxamine. In conclusion, patients with BDD have markedly high levels of distress, are highly symptomatic, and have poor well-being in the domains of depression, anxiety, somatic symptoms, and anger-hostility. All of these symptoms significantly improved with fluvoxamine. Keywordsbody dysmorphic disorder; depression; anxiety; hostility; somatic symptoms Body dysmorphic disorder (BDD), also known as dysmorphophobia, is a distressing and relatively common disorder (1-4). BDD frequently causes impaired functioning, such as social isolation and difficulties in occupational and academic functioning (1,2). Patients with BDD also have notably poor mental health-related quality of life (5) and high lifetime rates of psychiatric hospitalization (48%), suicidal ideation (45%-82%), and suicide attempts (22%-24%) (1,6). However, relatively little is known about non-BDD symptoms and well-being in patients with BDD.Regarding non-BDD symptoms in patients with this disorder, BDD pharmacotherapy studies have reported mild to moderate depressive symptoms on the Hamilton Depression Rating Scale (HAM-D) (7,8) and the MADRS (8). A report of patients who were treated with medication, intensive cognitive behavioral therapy, and rehabilitation in a residential treatment setting found that BDD patients had higher pre-treatment scores on the HAM-D and Hamilton Anxiety (HAM-A) scale than patients with obsessive compulsive disorder (OCD) treated in the same setting (9); BDD patients' HAM-A scores were in the moderate to severe range. In a small open-label BDD fluvoxamine study (n = 12) by Perugi and colleagues, on the self-report Hopkins Symptom Checklist-90, subjects reported that they were distressed by depression "moderately" to "quite a bit" and by anxiety "a little bit" to "moderately" (10). BDD patients also have elevated levels of perceived stress, with scores that are notably higher than those in a large national probability sample and in most normal, medical, and psychiatric samples (11).In this study, we assessed symptoms and well-being in the domains of depression, anxiety, somatic/somatization, and anger-hostility using ...

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Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia)

Cited by 100 publications

References 0 publications

The pathophysiology of body dysmorphic disorder

The pathophysiology of body dysmorphic disorder

Cognitive–behavioural therapy for body dysmorphic disorder

Depression, Anxiety, Anger, and Somatic Symptoms in Patients with Body Dysmorphic Disorder

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