New therapy for people suffering from body dysmorphic disorder

University of MontrealJun 29 2010

A nose job to treat a mental health problem? Teeth whitening to overcome a severe anxiety disorder? These are just two procedures that people with body dysmorphic disorder (BDD) have traditionally turned to in order to deal with body-related concerns. The excessive use of (and dissatisfaction with) cosmetic treatments, along with obsessive rituals and social isolation, is what scientists from the Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital, affiliated with the University of Montreal, are hoping to fight with a novel therapy to treat BDD.

BDD is not a well-known disease: it is characterized by a significant dissatisfaction with one's appearance, particularly with perceived flaws. Included in the category of obsessive-compulsive disorders, this mental health problem leads to ritual behaviours and social isolation. Although any part of the body may become the subject of these obsessions, those who suffer from BDD most often focus on their skin, eyes, nose, teeth, buttocks, stomach, hair or chest.

Kieron O'Connor, director of the Obsessive-Compulsive Disorder and Tic Disorder Studies Centre at Louis-H. Lafontaine Hospital, said that people coping with BDD seek out in particular plastic surgeons, orthodontists and esthetic professionals to alleviate their suffering. "However, what they really need is psychological support and assistance," said Dr. O'Connor, who is also a researcher at the University of Montreal Department of Psychiatry and the Universit- du Quebec en Outaouais Department of Psychology.

To help people struggling with BDD, Dr. O'Connor and Annie Taillon, a doctoral student in psychology, developed a specialized and innovative cognitive behavioural therapy in collaboration with their team at the Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital. "Our preliminary results are very promising," explained Ms. Taillon. "We observed a clear decrease in appearance-related fixations among participants and a reduction by more than half in ritualized behaviours. Nearly one third of the depressive symptoms associated with these fixations also disappeared."

The benefits of this therapy are very real; however, too few people dare to ask for help. By the nature of their illness, these patients are reluctant to go out in public, making a visit to the clinic a significant hurdle.

Kimberly is a woman who has benefited from the program. Speaking under an assumed name, she agreed to share the scope of her daily suffering: "I was ashamed to go out in public; I avoided all social activities. When I heard about this research project, it was a great relief for me. Finally, there was an explanation for my problems and, above all, a solution. This therapy helped me break free of my fixations and go back to work. I highly recommend it. "

Although BDD is little known, the disease is thought to affect over 350,000 Canadians, all of whom experience the same suffering, fears and turn to the same rituals and cosmetic procedures to avoid addressing the real nature of their illness. Nevertheless, these attempts to solve their problems reflect a true desire to end their suffering. Hair salons, dental offices, cosmetic surgery centres or a psychologist's chair? For people with body dysmorphic disorder, knocking on the right door is the true challenge.

Body Dysmorphic Disorder (BDD)

• Over 350,000 Canadians are estimated to suffer from BDD
• Specific populations: students (2 percent to 13.1 percent); clients of cosmetic surgery clinics (6 percent to 20 percent)
• Affects both men and women
• Rates of suicidal ideation (57.8 percent) and suicide attempts (2.6 percent)

Preliminary findings

• Specialized therapy for a period of 20 weeks
• Average reduction of 46 percent in appearance-related fixations
• Average reduction of 53 percent in ritualized behaviours associated with these fixations (e.g., looking in the mirror, applying makeup, skin picking at the location of a perceived imperfection, etc.)
• Average reduction of 34 percent in associated depressive symptoms

Researchers are currently seeking participants for their Montreal-based study. Anyone interested may contact Karine Bergeron at 514-251-4015, extension 3585.