FLUOXETINE IN PEDIATRIC BODY DYSMORPHIC DISORDER

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 身体变形障碍（BDD）患者是外表正常的人，他们痛苦地专注于自己外表上的想象或轻微缺陷。 BDD患者的妄想、精神病住院、自杀意念和企图的发生率很高，而不是表现出对外表的普通敏感性的简单夸大。 BDD严重致残，导致社会，学术和职业功能的重大损害。 许多病人都被困在家里。 虽然没有关于BDD患病率的流行病学研究，但估计在一般人群中高达1.9%，并且在12%的精神科门诊患者中发现了BDD。 BDD通常始于儿童或青少年，但其在儿科人群中的治疗尚未研究。最近的数据表明，成人BDD可能对5-羟色胺再摄取抑制剂（SRI）如氟西汀有反应。病例报告的初步结果表明，SRI也可能有效治疗儿童和青少年的BDD。 看来，与成人一样，SRI也可能有效治疗妄想性BDD（妄想性障碍，躯体型）儿童和青少年。 本研究是首个氟西汀治疗儿童和青少年BDD的大规模、双盲、安慰剂对照药物试验。 假设：假设氟西汀耐受性良好，在治疗儿童和青少年BDD症状方面比安慰剂更有效，妄想程度不能预测氟西汀反应-即，自知力较差的受试者与自知力较好的受试者一样可能产生应答，氟西汀应答者的妄想症将显著改善，包括妄想症患者，共病重度抑郁症或强迫症不会预测氟西汀应答，最后，疾病严重程度不会预测氟西汀应答。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Patients with Body Dysmorphic Disorder (BDD) are normal-appearing individuals who are painfully preoccupied with an imagined or slight defect in their appearance. Rather than exhibiting a simple exaggeration of common sensitivity about appearance, BDD patients have high rates of delusionality, psychiatric hospitalization, and suicidal ideation and attempts. BDD is severely disabling, resulting in significant impairment in social, academic, and occupational functioning. Many patients become housebound. Although there are no epidemiological studies of BDD's prevalence, there are estimates as high as 1.9% of the general population, and BDD has been found in 12% of psychiatric outpatients. BDD usually begins in childhood or adolescence, but its treatment in pediatric populations has not been investigated. Recent data suggests that adults with BDD may respond to serotonin reuptake inhibitors (SRIs) such as fluoxetine. Preliminary findings from case reports suggest that SRIs may also be effective in the treatment of BDD in children and adolescents. It appears that, as in adults, SRIs may also be effective in the treatment of children and adolescents with delusional BDD (delusional disorder, somatic type). This study is the first large-scale, double-blind, placebo-controlled medication trial of fluoxetine for children and adolescents with BDD. Hypothesis: The hypotheses are that fluoxetine will be well tolerated and more effective than placebo in treating BDD symptoms in children and adolescents, the degree of delusionality will not predict fluoxetine response--i.e., that subjects with poorer insight will be as likely to respond as subjects with better insight, delusionality will significantly improve in fluoxetine responders, including in delusional patients, comorbid major depression or OCD will not predict fluoxetine response and finally, that illness severity will not predict fluoxetine response.