Long-term outcomes of smartphone-delivered cognitive behavior therapy for body dysmorphic disorder: A one-year naturalistic follow-up

Ivar Snorrason , Susanne S. Hoeppner , Dalton Klare , Hilary Weingarden , Jennifer L. Greenberg , Rebecca M. Berger-Gutierrez , Emily E. Bernstein , Rachel C. Vanderkruik , Oliver Harrison , Sabine Wilhelm
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Abstract

Background

Body dysmorphic disorder (BDD) is an often chronic and impairing psychiatric condition. Research shows that smartphone-delivered cognitive behavior therapy (CBT) with coaching may be a scalable and effective treatment for BDD. However, evidence for long-term gain maintenance is limited.

Objectives

The aim of the current study was to examine the long-term outcomes of a smartphone-based CBT for BDD.

Method

Adults with a primary diagnosis of BDD who completed a 12-week course of smartphone-delivered CBT with coach support were evaluated 3- and 12-months posttreatment. Symptom severity, remission and responder status were assessed with the clinician-rated Yale-Brown Obsessive-Compulsive Scale modified for BDD (BDD-YBOCS). Secondary outcomes were also evaluated and included BDD-related insight, depression, functioning and quality of life. Data were analyzed using four different approaches to missing data, with maximum likelihood estimation as the main approach.

Results

There was significant attrition from posttreatment (n = 57) to 3-month (n = 49) and 12-month (n = 33) follow-up. The mean BDD-YBOCS severity score remained stable during the follow-up period [Estimated Mean (SE) at posttreatment, 3-months, and 12-months = 18.7(1.1), 18.9(1.2) and 18.8(1.3), respectively]. The proportion of participants responding to treatment and in remission remained relatively unchanged as well (63 % responders and 46 % remitters at posttreatment, 54 % and 35 % at 3-month follow-up, and 61 % and 37 % at 12-month follow-up, respectively). Posttreatment gains in BDD-related insight, functioning, and quality of life were maintained; there were small increases in depression (ES = 0.36) from posttreatment to 12-month follow-up.

Conclusions

Improvements after coach-supported smartphone-based CBT for BDD are maintained one year after treatment.
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来源期刊
CiteScore
6.50
自引率
9.30%
发文量
94
审稿时长
6 weeks
期刊介绍: Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions
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