January 21, 2009

Therapy helps those obsessed with looks

Medication and psychotherapy can benefit people obsessive about their physical appearance, a researcher in South Africa says.

Jonathan Ipser of the MRC Research Unit for Anxiety and Stress Disorders at the University of Stellenbosch in South Africa said body dysmorphic disorder affects as many as 1 in 20 people. Patients suffering from BDD worry obsessively about their physical appearance, with concerns frequently but not exclusively focused on the skin, hair and nose. They often have very low levels of self-esteem, Ipser said. Many are diagnosed with depression and about one-quarter may attempt suicide.

Given the number of people suffering from BDD and the level of distress caused, it is surprising that so little data is available on treatments," Ipser said in a statement.

Ipser and colleagues analyzed data from four trials, involving 169 patients. The researchers found more than half of people treated in a single trial with the antidepressant fluoxetine for 12 weeks showed improvement, compared to less than one-quarter of those given a placebo. In two 12-week trials of cognitive behavioral therapy, symptom severity was significantly reduced. Both types of treatment were well tolerated, with no severe adverse effects reported, Ipser said.

The review, published in the Cochrane Library, concluded much more research is required to determine the most effective treatment and whether both approaches should be used in combination.