Cognitive-behavioural therapy and recovery of a delusional dysmorphophobia case.

BACKGROUND: We present the application of cognitive-behavioural therapy in a clinical case diagnosed with delusional dysmorphophobia.

METHOD: The psychometric scales used for evaluation were the Positive and Negative Syndrome Scale for Schizophrenia, Beck Anxiety and Depression inventories, the Rosenberg Self-Esteem Scale along with the degree of conviction in the delusional belief and in alternative explanations, and social functioning measured by patient reporting. The therapy included cognitive and behavioural techniques: evidence analysis, search for alternative explanations, logical and functional analysis, reality testing, progressive relaxation techniques, in vivo and imaginal exposure therapy. Evaluations were performed before and after the treatment and then at follow-up after 12 and 24 months.

RESULTS: Progressively, the delusional conviction disappeared. There were significant improvements at an emotional level and the patient recovered social and work  functioning.

CONCLUSIONS: The need to use psychological treatments for people with delusional disorder as first choice treatment must be considered.