CONTEXT: Medication and cognitive behavioral treatment are the best-established treatments for social anxiety disorder, yet many individuals remain symptomatic after treatment. OBJECTIVE: To determine whether combined medication and cognitive behavioral treatment is superior to either monotherapy or pill placebo. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING:Research clinics at Columbia University and Temple University. PARTICIPANTS: One hundred twenty-eight individuals with a primary DSM-IV diagnosis of social anxiety disorder. INTERVENTIONS:Cognitive behavioral group therapy (CBGT), phenelzine sulfate, pill placebo, and combined CBGT plus phenelzine. MAIN OUTCOME MEASURES: Liebowitz Social Anxiety Scale and Clinical Global Impression (CGI) scale scores at weeks 12 and 24. RESULTS: Linear mixed-effects models showed a specific order of effects, with steepest reductions in Liebowitz Social Anxiety Scale scores for the combined group, followed by the monotherapies, and the least reduction in the placebo group (Williams test = 4.97, P < .01). The CGI response rates in the intention-to-treat sample at week 12 were 9 of 27 (33.3%) (placebo), 16 of 34 (47.1%) (CBGT), 19 of 35 (54.3%) (phenelzine), and 23 of 32 (71.9%) (combined treatment) (chi(2)(1) = 8.76, P < .01). Corresponding remission rates (CGI = 1) were 2 of 27 (7.4%), 3 of 34 (8.8%), 8 of 35 (22.9%), and 15 of 32 (46.9%) (chi(2)(1) = 15.92, P < .01). At week 24, response rates were 9 of 27 (33.3%), 18 of 34 (52.9%), 17 of 35 (48.6%), and 25 of 32 (78.1%) (chi(2)(1) = 12.02, P = .001). Remission rates were 4 of 27 (14.8%), 8 of 34 (23.5%), 9 of 35 (25.7%), and 17 of 32 (53.1%) (chi(2)(1) = 10.72, P = .001). CONCLUSION: Combined phenelzine and CBGT treatment is superior to either treatment alone and to placebo on dimensional measures and on rates of response and remission.
RCT Entities:
CONTEXT: Medication and cognitive behavioral treatment are the best-established treatments for social anxiety disorder, yet many individuals remain symptomatic after treatment. OBJECTIVE: To determine whether combined medication and cognitive behavioral treatment is superior to either monotherapy or pill placebo. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Research clinics at Columbia University and Temple University. PARTICIPANTS: One hundred twenty-eight individuals with a primary DSM-IV diagnosis of social anxiety disorder. INTERVENTIONS: Cognitive behavioral group therapy (CBGT), phenelzine sulfate, pill placebo, and combined CBGT plus phenelzine. MAIN OUTCOME MEASURES: Liebowitz Social Anxiety Scale and Clinical Global Impression (CGI) scale scores at weeks 12 and 24. RESULTS: Linear mixed-effects models showed a specific order of effects, with steepest reductions in Liebowitz Social Anxiety Scale scores for the combined group, followed by the monotherapies, and the least reduction in the placebo group (Williams test = 4.97, P < .01). The CGI response rates in the intention-to-treat sample at week 12 were 9 of 27 (33.3%) (placebo), 16 of 34 (47.1%) (CBGT), 19 of 35 (54.3%) (phenelzine), and 23 of 32 (71.9%) (combined treatment) (chi(2)(1) = 8.76, P < .01). Corresponding remission rates (CGI = 1) were 2 of 27 (7.4%), 3 of 34 (8.8%), 8 of 35 (22.9%), and 15 of 32 (46.9%) (chi(2)(1) = 15.92, P < .01). At week 24, response rates were 9 of 27 (33.3%), 18 of 34 (52.9%), 17 of 35 (48.6%), and 25 of 32 (78.1%) (chi(2)(1) = 12.02, P = .001). Remission rates were 4 of 27 (14.8%), 8 of 34 (23.5%), 9 of 35 (25.7%), and 17 of 32 (53.1%) (chi(2)(1) = 10.72, P = .001). CONCLUSION: Combined phenelzine and CBGT treatment is superior to either treatment alone and to placebo on dimensional measures and on rates of response and remission.
Authors: Shyamal D Peddada; Edward K Lobenhofer; Leping Li; Cynthia A Afshari; Clarice R Weinberg; David M Umbach Journal: Bioinformatics Date: 2003-05-01 Impact factor: 6.937
Authors: Jonathan R T Davidson; Edna B Foa; Jonathan D Huppert; Francis J Keefe; Martin E Franklin; Jill S Compton; Ning Zhao; Kathryn M Connor; Thomas R Lynch; Kishore M Gadde Journal: Arch Gen Psychiatry Date: 2004-10
Authors: Carlos Blanco; Muhammad S Raza; Franklin R Schneier; Michael R Liebowitz Journal: Int J Neuropsychopharmacol Date: 2003-12 Impact factor: 5.176
Authors: Dan J Stein; David S Baldwin; Borwin Bandelow; Carlos Blanco; Leonardo F Fontenelle; Sing Lee; Hisato Matsunaga; David Osser; Murray B Stein; Michael van Ameringen Journal: Curr Psychiatry Rep Date: 2010-10 Impact factor: 5.285
Authors: Thomas L Rodebaugh; Natasha A Tonge; Marilyn L Piccirillo; Eiko Fried; Arielle Horenstein; Amanda S Morrison; Philippe Goldin; James J Gross; Michelle H Lim; Katya C Fernandez; Carlos Blanco; Franklin R Schneier; Ryan Bogdan; Renee J Thompson; Richard G Heimberg Journal: J Consult Clin Psychol Date: 2018-10
Authors: Annemarie Abbing; Anne Ponstein; Susan van Hooren; Leo de Sonneville; Hanna Swaab; Erik Baars Journal: PLoS One Date: 2018-12-17 Impact factor: 3.240
Authors: Mark B Powers; Johnna L Medina; Stephanie Burns; Brooke Y Kauffman; Marie Monfils; Gordon J G Asmundson; Allison Diamond; Christa McIntyre; Jasper A J Smits Journal: Cogn Behav Ther Date: 2015-02-23
Authors: Stefan G Hofmann; Jasper A J Smits; David Rosenfield; Naomi Simon; Michael W Otto; Alicia E Meuret; Luana Marques; Angela Fang; Candyce Tart; Mark H Pollack Journal: Am J Psychiatry Date: 2013-07 Impact factor: 18.112
Authors: Martin A Katzman; Pierre Bleau; Pierre Blier; Pratap Chokka; Kevin Kjernisted; Michael Van Ameringen; Martin M Antony; Stéphane Bouchard; Alain Brunet; Martine Flament; Sophie Grigoriadis; Sandra Mendlowitz; Kieron O'Connor; Kiran Rabheru; Peggy M A Richter; Melisa Robichaud; John R Walker Journal: BMC Psychiatry Date: 2014-07-02 Impact factor: 3.630
Authors: Pim Cuijpers; Marit Sijbrandij; Sander L Koole; Gerhard Andersson; Aartjan T Beekman; Charles F Reynolds Journal: World Psychiatry Date: 2014-02 Impact factor: 49.548
Authors: Pim Cuijpers; Marit Sijbrandij; Sander L Koole; Gerhard Andersson; Aartjan T Beekman; Charles F Reynolds Journal: World Psychiatry Date: 2013-06 Impact factor: 49.548
Authors: Joseph K Carpenter; Leigh A Andrews; Sara M Witcraft; Mark B Powers; Jasper A J Smits; Stefan G Hofmann Journal: Depress Anxiety Date: 2018-02-16 Impact factor: 6.505