Feasibility Pilot Study of Internet-based Cognitive Behavioral Therapy (CBT) for Body Dysmorphic Disorder With Global Recruitment

Inclusion criteria

• Current outpatient status (not currently admitted for inpatient care)
• Patient is fluent in English
• Patient has regular access to a computer with an Internet connection
• Patient has adequate skills to use the Internet effectively.
• Patient provides informed consent (both verbal, and click yes to consent on secure web page)
• Patient is 18 years of age or older (able to provide government issued photo ID)
• Patient has primary diagnosis of DSM-5 Body Dysmorphic Disorder, (determined using the SCID-5 module "G" which assesses diagnostic criteria on obsessive compulsive spectrum disorders)
• score ≥ 4 on the Body Dysmorphic Disorder Questionnaire (BDDQ),
• score ≥ 9 on the Dysmorphic Concern Questionnaire (DCQ)
• score ≥ 20 on the Body Dysmorphic Disorder Modification of the Yale Brown Obsessive Compulsive Scale (BDD-YBOCS).

Exclusion criteria

• Patient received Cognitive Behavior Therapy for Body Dysmporphic Disorder in the 12 months preceding treatment
• Patient changed psychotropic medications within the 12 weeks before treatment
• Patient receiving other ongoing psychotherapy at the time,
• Patient did not have access to a 24 hour psychiatric emergency center
• Patient could not provide an emergency contact person.
• Current substance dependence (assessed with M.I.N.I. 7.0, AUDIT, DUDIT)
• Lifetime bipolar disorder diagnosis (assessed with M.I.N.I. 7.0 and self-report)
• Psychosis present
• Severe depression (assessed with M.I.N.I., MADRS-S score ≥ 35)
• Personality disorder diagnosis (self-report and video-conference diagnostic interview),
• Lifetime history of suicide attempts (self-report) or clinically significant current suicidal ideation (≥ 5 on item 9 of MADRS-S; Columbia Suicide Severity Rating Scale (C-SSRS Lifetime Recent) - Clinical Version: Recent (past month) - Most Severe Ideation score ≥ 4).
• Additionally, eligibility continues to be assessed on an ongoing basis after initial inclusion. The MADRS-S, Appearance Anxiety Questionnaire (AAI), and Adverse Events Questionnaire (AEQ) are administered weekly in order to ensure that the treatment study continues to be a safe and appropriate level of care for participants.