Predictors of Remission from Body Dysmorphic Disorder After Internet-delivered Cognitive Behavior Therapy: a Machine Learning Approach

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2020 May 21

PMID 32429939

Citations 18

Authors

Oskar Flygare

Jesper Enander

Erik Andersson

Brjann Ljotsson

Volen Z Ivanov

David Mataix-Cols

Christian Ruck

Affiliations

Soon will be listed here.

Abstract

Background: Previous attempts to identify predictors of treatment outcomes in body dysmorphic disorder (BDD) have yielded inconsistent findings. One way to increase precision and clinical utility could be to use machine learning methods, which can incorporate multiple non-linear associations in prediction models.

Methods: This study used a random forests machine learning approach to test if it is possible to reliably predict remission from BDD in a sample of 88 individuals that had received internet-delivered cognitive behavioral therapy for BDD. The random forest models were compared to traditional logistic regression analyses.

Results: Random forests correctly identified 78% of participants as remitters or non-remitters at post-treatment. The accuracy of prediction was lower in subsequent follow-ups (68, 66 and 61% correctly classified at 3-, 12- and 24-month follow-ups, respectively). Depressive symptoms, treatment credibility, working alliance, and initial severity of BDD were among the most important predictors at the beginning of treatment. By contrast, the logistic regression models did not identify consistent and strong predictors of remission from BDD.

Conclusions: The results provide initial support for the clinical utility of machine learning approaches in the prediction of outcomes of patients with BDD.

Trial Registration: ClinicalTrials.gov ID: NCT02010619.

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