TY - JOUR
T1 - Cognitive behavioral therapy for patients with social anxiety disorder who remain symptomatic following antidepressant treatment
T2 - A randomized, assessor-blinded, controlled trial
AU - Yoshinaga, Naoki
AU - Matsuki, Satoshi
AU - Niitsu, Tomihisa
AU - Sato, Yasunori
AU - Tanaka, Mari
AU - Ibuki, Hanae
AU - Takanashi, Rieko
AU - Ohshiro, Keiko
AU - Ohshima, Fumiyo
AU - Asano, Kenichi
AU - Kobori, Osamu
AU - Yoshimura, Kensuke
AU - Hirano, Yoshiyuki
AU - Sawaguchi, Kyoko
AU - Koshizaka, Masaya
AU - Hanaoka, Hideki
AU - Nakagawa, Akiko
AU - Nakazato, Michiko
AU - Iyo, Masaomi
AU - Shimizu, Eiji
N1 - Publisher Copyright:
© 2016 The Author(s) Published by S. Karger AG, Basel.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2016/6/14
Y1 - 2016/6/14
N2 - Background: Although antidepressants are still a commonly used treatment for social anxiety disorder (SAD), a significant proportion of patients fail to remit following antidepressants. However, no standard approach has been established for managing such patients. This study aimed to examine the effectiveness of cognitive behavioral therapy (CBT) as an adjunct to usual care (UC) compared with UC alone in SAD patients who remain symptomatic following antidepressant treatment. Methods: This was a prospective randomized open-blinded end-point study with two parallel groups (CBT + UC, and UC alone, both for 16 weeks) conducted from June 2012 to March 2014. SAD patients who remain symptomatic following antidepressant treatment were recruited, and a total sample size of 42 was set based on pilot results. Results: Patients were randomly allocated to CBT + UC (n = 21) or UC alone (n = 21). After 16 weeks, adjusted mean reduction in the Liebowitz Social Anxiety Scale from baseline for CBT + UC and UC alone was ? 40.87 and 0.68, respectively; the between-group difference was ? 41.55 ( ? 53.68 to ? 29.42, p < 0.0001). Response rates were 85.7 and 10.0% for CBT + UC and UC alone, respectively (p < 0.0001). The corresponding remission rates were 47.6 and 0.0%, respectively (p = 0.0005). Significant differences were also found in favor of CBT + UC for social anxiety symptoms, depressive symptoms, and functional impairment. Conclusions: Our results suggest that in SAD patients who have been ineffectively treated with antidepressants, CBT is an effective treatment adjunct to UC over 16 weeks in reducing social anxiety and related symptoms.
AB - Background: Although antidepressants are still a commonly used treatment for social anxiety disorder (SAD), a significant proportion of patients fail to remit following antidepressants. However, no standard approach has been established for managing such patients. This study aimed to examine the effectiveness of cognitive behavioral therapy (CBT) as an adjunct to usual care (UC) compared with UC alone in SAD patients who remain symptomatic following antidepressant treatment. Methods: This was a prospective randomized open-blinded end-point study with two parallel groups (CBT + UC, and UC alone, both for 16 weeks) conducted from June 2012 to March 2014. SAD patients who remain symptomatic following antidepressant treatment were recruited, and a total sample size of 42 was set based on pilot results. Results: Patients were randomly allocated to CBT + UC (n = 21) or UC alone (n = 21). After 16 weeks, adjusted mean reduction in the Liebowitz Social Anxiety Scale from baseline for CBT + UC and UC alone was ? 40.87 and 0.68, respectively; the between-group difference was ? 41.55 ( ? 53.68 to ? 29.42, p < 0.0001). Response rates were 85.7 and 10.0% for CBT + UC and UC alone, respectively (p < 0.0001). The corresponding remission rates were 47.6 and 0.0%, respectively (p = 0.0005). Significant differences were also found in favor of CBT + UC for social anxiety symptoms, depressive symptoms, and functional impairment. Conclusions: Our results suggest that in SAD patients who have been ineffectively treated with antidepressants, CBT is an effective treatment adjunct to UC over 16 weeks in reducing social anxiety and related symptoms.
KW - Antidepressant
KW - Cognitive behavioral therapy
KW - Cognitive therapy
KW - Randomized controlled trial
KW - Residual symptoms
KW - Social anxiety
KW - Social phobia
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U2 - 10.1159/000444221
DO - 10.1159/000444221
M3 - Article
C2 - 27230862
AN - SCOPUS:84975690660
VL - 85
SP - 208
EP - 217
JO - Psychotherapy and Psychosomatics
JF - Psychotherapy and Psychosomatics
SN - 0033-3190
IS - 4
ER -