The prevalence of body dysmorphic disorder (BDD) among adolescents and young adults has gained increasing recognition in recent years. This mental health condition, which involves a debilitating obsession with perceived flaws in one’s appearance, often leads individuals to engage in maladaptive behaviors and significantly diminishes their quality of life. Despite the high incidence of BDD in young people, the disorder remains relatively understudied and undertreated. The urgent need for effective interventions in this demographic has prompted researchers to explore innovative approaches, one of which includes internet-based therapeutic interventions.
Recent studies have highlighted the potential of internet-based cognitive behavioral therapy (iCBT) as a viable treatment option for various mental health disorders. This method combines the accessibility of online resources with therapeutic guidance, making it particularly suitable for adolescents and young adults who may be reluctant to seek traditional face-to-face therapy. The efficacy of such interventions in treating BDD has not been extensively researched, which made the recent randomized controlled trial by Schmidt et al. a pivotal contribution to the existing body of knowledge.
In this study, a total of 45 adolescents and young adults aged 15 to 21 from German-speaking countries participated in a rigorous investigation of iCBT’s effect on BDD. The participants were randomly assigned to either a 12-session internet-based cognitive behavioral therapy program or a supportive online therapy group, which served as the active control condition. This design allowed researchers to meticulously evaluate the efficacy of iCBT in terms of symptom reduction and overall improvement in quality of life.
To measure the outcomes of the intervention, the researchers employed the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) as the primary metric. This scale is designed to quantify the severity of BDD symptoms, providing a standardized measure that is sensitive to changes over time. Alongside this primary outcome measure, various secondary outcomes were assessed, including changes in beliefs related to appearance, self-rated symptom severity, and overall quality of life.
The results of the study were compelling. Participants receiving iCBT exhibited a significant reduction in BDD symptoms, outperforming those in the supportive therapy group. This was evidenced by a statistically significant difference in BDD-YBOCS scores, with an impressive effect size indicative of the intervention’s robustness. Beyond the primary outcome, many secondary measures also demonstrated substantial improvements, suggesting that iCBT not only alleviates symptoms but may also promote more adaptive coping mechanisms and a healthier self-image.
In addition to immediate effects, long-term benefits were noted in the study. Follow-up data indicated that gains made during the treatment phase were sustained for at least four weeks after the conclusion of the intervention. This stability suggests that the skills learned through iCBT may empower adolescents to manage their symptoms more effectively in the long run, which is particularly encouraging for a population that often faces ongoing challenges with mental health.
Another noteworthy aspect of the findings is the higher rates of remission and symptom response observed among participants receiving iCBT. Sixty-one percent of those in the iCBT group achieved remission compared to none in the control group, showcasing the potential of this intervention as a lifeline for those struggling with BDD. The response rates further underscored the effectiveness, with two-thirds of participants showing meaningful improvement, setting a precedent for future therapeutic strategies.
The conclusions drawn from this study not only highlight the efficacy of iCBT but also illuminate the critical gap in treatment options for adolescent BDD. The findings advocate for integrating such innovative approaches into standard care practices, particularly in light of the stigma often associated with traditional mental health treatment settings that may deter young people from seeking help.
Pre-registration of the study adds a further layer of credibility, ensuring that the research adheres to rigorous scientific standards and remains transparent throughout its implementation. By documenting the methodology and anticipated outcomes in advance, the researchers bolster confidence in both the results and their implications for future research.
These groundbreaking findings lay the groundwork for future studies that could explore more tailored iCBT approaches. Potential expansions might include variations in treatment length, frequency, or the incorporation of additional therapeutic elements, such as peer support or community engagement initiatives. Enhanced understanding of how different components of iCBT contribute to its effectiveness will facilitate optimized interventions for a range of mental health disorders, not just BDD.
Overall, this trial marks a significant milestone in understanding how technologically-enabled therapeutic modalities can effectively address the complexities of adolescent mental health issues. The need for accessible, engaging, and effective treatment options has never been clearer, and the promise of iCBT in this domain holds great potential for transforming the lives of countless young individuals battling body dysmorphic disorder.
As society continues to grapple with the implications of mental health on overall well-being, studies like these are essential in informing clinical practice and guiding future research. The commitment to exploring innovative solutions such as internet-based therapy renews hope for adolescents suffering from BDD and paves the way for broader acceptance and integration of digital therapeutic tools in mental health care.
The path forward is about harnessing the insights gained from this and similar studies to advocate for systemic changes in how mental health interventions are developed and delivered. By ensuring that adolescents and young adults have access to effective treatment options, we can begin to close the treatment gap that currently plagues the field, promoting a healthier future for the next generation.
Ultimately, the urgent task is to continue to address and destigmatize mental health disorders, providing effective resources like iCBT to empower young people to navigate their mental health journeys with confidence and resilience. The hope is that by embracing such innovative interventions, we can foster a culture of well-being that prioritizes mental health as a critical component of holistic health care.
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Subject of Research: Body Dysmorphic Disorder in Adolescents and Young Adults
Article Title: Efficacy of an internet-based, therapist-guided cognitive behavioral therapy intervention for adolescents and young adults with body dysmorphic disorder: a randomized controlled trial
Article References:
Schmidt, M., Schoenenberg, K., Engelkamp, J.E. et al. Efficacy of an internet-based, therapist-guided cognitive behavioral therapy intervention for adolescents and young adults with body dysmorphic disorder: a randomized controlled trial.
BMC Psychiatry 25, 374 (2025). https://doi.org/10.1186/s12888-025-06797-1
Image Credits: Scienmag.com
DOI: https://doi.org/10.1186/s12888-025-06797-1
Keywords: Body Dysmorphic Disorder, Internet-Based Therapy, Cognitive Behavioral Therapy, Adolescents, Young Adults, Mental Health, Randomized Controlled Trial, Efficacy, Therapeutic Intervention, Quality of Life
