Comparative Efficacy and Acceptability for Psychological Interventions on Body Dysmorphic Disorders: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Body dysmorphic disorder (BDD) is a psychiatric disorder, which characterized by an excessive preoccupation with perceived flaws in physical appearance that appear minor or are completely unobservable to others. Currently, some psychological interventions have shown significant efficacy in the treatment of BDD. This network meta-analysis (NMA) aimed to investigate the efficacy and acceptability of different psychological interventions for BDD in adults.

A comprehensive search was conducted in 5 databases from 1 January 2010 to 1 January 2024. Using random-effects models, pairwise and network meta-analyses were conducted to compare interventions directly and indirectly for outcomes with 95% confidence intervals (CIs).

A total of 2070 records were found, and 13 studies (763 participants) assessing six different psychological interventions were included. Cognitive behavioral therapy (CBT) was the only intervention that demonstrated significant efficacy in reducing BDD symptoms compared to the waiting list (SMD = -2.56, 95%CI: -3.92 to -1.20; P-score = 0.90). There was no significant difference in acceptability between any of the psychological interventions, as indicated by the 95% CIs.

CBT may be a promising intervention for the treatment of BDD. However, the small sample size of the other psychological interventions and high heterogeneity in some NMA have limited the generalizability of our findings. Therefore, this study must be understood with caution, and further investigation is warranted when more relevant studies emerge.