Efficiency of Virtual Reality Exposure Therapy in the Management of Body Dysmorphic Disorders in Female Adolescents With Anorexia Nervosa

Study Overview
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Brief Summary
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Anorexia nervosa is defined in DSM V as a quantitative and qualitative dietary restriction resulting in significant weight loss, intense fear of weight gain, altered weight and body shape perception (body dysmorphic disorder) and low self-esteem influenced by weight or body shape. Body dysmorphic disorder is the most difficult symptom to manage in anorexia nervosa and its persistence is a factor associated with relapse. Virtual reality exposure therapy has proven its effectiveness in the management of post-traumatic stress disorder in the military and is a widely used therapy. The effectiveness of this treatment using new technologies has not yet been studied for the treatment of body dysmorphic disorder in anorexia nervosa and is not used routinely. It could represent an interesting alternative to the physical approach in psychomotor therapy, traditionally offered to patients suffering from anorexia nervosa. It is important to evaluate the effectiveness of virtual reality exposure therapy in the management of body dysmorphic disorder in patients with anorexia nervosa by comparing these two care techniques.

Detailed Description
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The aim of this study is to evaluate the effectiveness of Virtual Reality Exposure Therapy in the management of body dysmorphic disorder in patients with anorexia nervosa, compared to the traditionally proposed body approach in psychomotor therapy.

Official Title
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Efficiency of Virtual Reality Exposure Therapy in the Management of Body Dysmorphic Disorder in Female Adolescents With Anorexia Nervosa: a Randomized, Controlled Superiority Study

Conditions
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Anorexia Nervosa

Intervention / Treatment
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* Behavioral: Virtual Reality Exposure Therapy sessions
* Behavioral: Psychomotor therapy sessions


Participation Criteria
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Eligibility Criteria
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Inclusion criteria : Female adolescents aged 13 to 18 with a diagnosis of anorexia nervosa of all types (including purgative and hyperphagic) according to the DSM-V French as first language agreed to participate in the study parental authority holders accepting her participation in the study affiliated to a social security system Patients will not be included in the study: with a somatic severity criterion: Total aphagia Body mass index (BMI) < 14kg/m² for those over 17 years of age, BMI < 13.2kg/m² for those aged 15-16 and BMI < 12.7kg/m² for those aged 13-14. Confusion Bradycardia <40/min, Tachycardia Blood pressure < 80/50mmHg Hypothermia <35.5°C Severe metabolic disorders: hypokalemia < 2.5 mmol/l, hyponatremia < 125mmol/l or hypernatremia > 150 mmol/l, hypophosphoremia < 0.5 mmol/l Acetonuria, hypoglycemia < 0.6g/l Creatinine elevation > 100micromol/l Cytolysis > 4N Leuconeutropenia <1000/mm3 Thrombocytopenia <6000000/mm3 Suicide attempt in the last month before inclusion Receiving benzodiazepine treatment outside the prescription limits. Psychotic patients or patients with psychoactive substance addiction according to MINI KID criteria (Sheehan DV et al. Reliability and validity of the Mini International Neuropsychiatric Interview for children and adolescents (MINI Kid). J Clin Psychiatry 2010;71(3):313-326).

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Reality Exposure Therapy<br>Female adolescents aged 13 to 18 are proposed virtual reality exposure therapy sessions, accompanied by a cognitive and behavioral therapy (CBT) therapist, to work on their body representations | Behavioral: Virtual Reality Exposure Therapy sessions<br>* Female adolescents aged 13 to 18 are proposed virtual reality exposure therapy sessions, accompanied by a cognitive and behavioral therapy (CBT) therapist, to work on their body representations<br>|
| Active Comparator: Psychomotor Therapy<br>Psychomotor therapy sessions are proposed to female adolescents aged 13 to 18 years, ac-companied by a psychomotor therapist, to work on their body representations. | Behavioral: Psychomotor therapy sessions<br>* Psychomotor therapy sessions are proposed to female adolescents aged 13 to 18 years, ac-companied by a psychomotor therapist, to work on their body representations.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Body Shape Questionnaire | The Body Shape Questionnaire (BSQ) measures concerns about body shape. The BSQ can be divided into 4 sub scores: avoidance and social shame of body exposure, body dissatisfaction with lower body parts, use of laxatives and vomiting to reduce body dissatisfaction and inappropriate cognitions and behaviours to control weight. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Eating Disorder Inventory | Eating Disorder Inventory (EDI-2) is a self questionnaire to assess the severity of symptoms of eating disorders and to evaluate their changes | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ANOREXIA NERVOSA, FEMALE ADOLESCENTS, BODY DYSMORPHIC DISORDER, VIRTUAL REALITY EXPOSURE THERAPY