Side Effects Hinder Adherence in Body Dysmorphic Disorder

Article excerpt

HOLLYWOOD, FLA. -- New treatment options for body dysmorphic disorder are becoming available, and success is built on patient adherence to medication and cognitive-be-havioral therapy. But adherence proved to be a problem for about one-third of patients in a longitudinal observational study.

Cost issues, side effects, and lack of certainty about efficacy were among medication barriers cited by patients in the study. Unavailability of cognitive-be-havioral therapy (CBT) was also an issue for some.

"The good news is we are starting to develop good treatments for body dysmorphic disorder," Dr. Katharine A. Phillips, professor of psychiatry at Brown University, Providence, R.I., said in an interview. Meications and CBT are the two recommended body dysmorphic disorder (BDD) treatments (Body Image 2008;5:13-27; Body Image 2008;5:39-49).

More data are needed on these treatments. Dr. Phillips said, including patient compliance. With funding from the National Institute of Mental Health, Dr. Phillips and her colleagues assessed a cohort of 136 people with BDD meeting DSM-VI criteria. They used validated measures of treatment adherence, including the Treatment Adherence Survey.

A total of 52 patients said their health care provider recommended medication to treat their body image concerns, and an additional 19 said their physician prescribed medications as sociated with their body dysmorphic disorder.

All 71 patient for whom medication was recommended in the past year reported taking it. However, not everyone was fully adherent, Dr. Phillips said at her poster during at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health. …