FLUOXETINE IN PEDIATRIC BODY DYSMORPHIC DISORDER

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 身体变形障碍(BDD)患者是外表正常的人，他们痛苦地全神贯注于自己外表上的想象或轻微缺陷。BDD患者并没有表现出对外表的常见敏感性的简单夸张，而是有很高的妄想率、精神病院住院率以及自杀念头和自杀企图。BDD严重致残，导致严重的社会、学习和职业功能障碍。许多病人不得不待在家里。虽然没有关于BDD患病率的流行病学研究，但据估计，BDD在普通人群中高达1.9%，在12%的精神科门诊患者中发现了BDD。 BDD通常开始于儿童或青春期，但其在儿科人群中的治疗尚未被调查。最近的数据表明，患有BDD的成年人可能对氟西汀等5-羟色胺再摄取抑制剂(SRIs)有反应。病例报告的初步结果表明，SRIs在治疗儿童和青少年BDD方面也可能有效。看来，与成人一样，SRIs在治疗患有妄想性BDD(妄想性障碍，躯体类型)的儿童和青少年方面也可能有效。这项研究是氟西汀治疗患有BDD的儿童和青少年的第一次大规模、双盲、安慰剂对照药物试验。 假设：假设氟西汀的耐受性良好，在治疗儿童青少年BDD症状方面比安慰剂更有效，妄想的程度不能预测氟西汀的反应--也就是说，视力较差的受试者和视力较好的受试者一样有可能有反应，妄想性在氟西汀应答者中显著改善，包括在妄想症患者中，合并严重的抑郁症或强迫症不能预测氟西汀的反应，最后，疾病的严重程度不能预测氟西汀的反应。

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.