Simone Salzer1,2, Annette Stefini3, Klaus-Thomas Kronmüller3, Eric Leibing1, Falk Leichsenring4, Peter Henningsen5, Hamid Peseschkian6, Günter Reich1, Rita Rosner7, Uwe Ruhl8, Yvonne Schopf9, Christiane Steinert4, Eva Vonderlin10, Regina Steil9. 1. Clinic of Psychosomatic Medicine and Psychotherapy, Georg August University Göttingen, Göttingen, Germany. 2. International Psychoanalytic University (IPU) Berlin, Berlin, Germany. 3. Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany. 4. Clinic of Psychosomatics and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany. 5. Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany. 6. Wiesbaden Academy of Psychotherapy, Wiesbaden, Germany. 7. Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany. 8. Department of Clinical Psychology and Psychotherapy, Georg August University Göttingen, Göttingen, Germany. 9. Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany. 10. Department of Psychology, University of Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: Although social anxiety disorder (SAD) has an early onset and is frequently found in adolescence, evidence for psychotherapeutic treatments of SAD in adolescents is rather scarce. Within the Social Phobia Psychotherapy Research Network (SOPHO-NET), we examined the efficacy of cognitive-behavioral (CBT) and psychodynamic therapy (PDT) compared to a waiting list (WL) in these patients. METHODS: In a multicenter randomized controlled superiority trial, 107 patients, aged 14-20 years, were randomized to CBT (n = 34), PDT (n = 34), or WL (n = 39). Assessments were made at baseline, at the end of treatment, and 6 and 12 months after termination. The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) applied by raters masked to the treatment condition was used as the primary outcome. As secondary outcomes, rates of response and remission and the Social Phobia Anxiety Inventory (SPAI) were used. RESULTS: Both treatments were superior to WL in the LSAS-CA (CBT: p = 0.0112, d = 0.61, 95% CI 0.14-1.08; PDT: p = 0.0261, d = 0.53, 95% CI 0.06-1.00). At the end of treatment, response rates were 66, 54, and 20% for CBT, PDT, and WL. The corresponding remission rates were 47, 34, and 6%, respectively. CBT and PDT were significantly superior to WL regarding remission (CBT: p = 0.0009, h = 1.0; PDT: p = 0.0135, h = 0.74), response (CBT: p = 0.0004, h = 0.97; PDT: p = 0.0056, h = 0.72), and the SPAI (CBT: p = 0.0021, d = 0.75, 95% CI 0.27-1.22; PDT: p = 0.0060, d = 0.66, 95% CI 0.19-1.13). Treatment effects were stable at 6- and 12-month follow-ups. CONCLUSIONS: These results are comparable to the large SOPHO-NET trial in adults (n = 495). Early treatments for social anxiety are needed in order to prevent chronic manifestation of SAD.
RCT Entities:
BACKGROUND: Although social anxiety disorder (SAD) has an early onset and is frequently found in adolescence, evidence for psychotherapeutic treatments of SAD in adolescents is rather scarce. Within the Social Phobia Psychotherapy Research Network (SOPHO-NET), we examined the efficacy of cognitive-behavioral (CBT) and psychodynamic therapy (PDT) compared to a waiting list (WL) in these patients. METHODS: In a multicenter randomized controlled superiority trial, 107 patients, aged 14-20 years, were randomized to CBT (n = 34), PDT (n = 34), or WL (n = 39). Assessments were made at baseline, at the end of treatment, and 6 and 12 months after termination. The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) applied by raters masked to the treatment condition was used as the primary outcome. As secondary outcomes, rates of response and remission and the Social Phobia Anxiety Inventory (SPAI) were used. RESULTS: Both treatments were superior to WL in the LSAS-CA (CBT: p = 0.0112, d = 0.61, 95% CI 0.14-1.08; PDT: p = 0.0261, d = 0.53, 95% CI 0.06-1.00). At the end of treatment, response rates were 66, 54, and 20% for CBT, PDT, and WL. The corresponding remission rates were 47, 34, and 6%, respectively. CBT and PDT were significantly superior to WL regarding remission (CBT: p = 0.0009, h = 1.0; PDT: p = 0.0135, h = 0.74), response (CBT: p = 0.0004, h = 0.97; PDT: p = 0.0056, h = 0.72), and the SPAI (CBT: p = 0.0021, d = 0.75, 95% CI 0.27-1.22; PDT: p = 0.0060, d = 0.66, 95% CI 0.19-1.13). Treatment effects were stable at 6- and 12-month follow-ups. CONCLUSIONS: These results are comparable to the large SOPHO-NET trial in adults (n = 495). Early treatments for social anxiety are needed in order to prevent chronic manifestation of SAD.
Authors: Jakob Mechler; Karin Lindqvist; Per Carlbring; Peter Lilliengren; Fredrik Falkenström; Gerhard Andersson; Naira Topooco; Robert Johansson; Nick Midgley; Julian Edbrooke-Childs; Hanne-Sofie J Dahl; Rolf Sandell; Agneta Thorén; Randi Ulberg; Katja Lindert Bergsten; Björn Philips Journal: Trials Date: 2020-06-29 Impact factor: 2.279
Authors: Karin Lindqvist; Jakob Mechler; Per Carlbring; Peter Lilliengren; Fredrik Falkenström; Gerhard Andersson; Robert Johansson; Julian Edbrooke-Childs; Hanne-Sofie J Dahl; Katja Lindert Bergsten; Nick Midgley; Rolf Sandell; Agneta Thorén; Naira Topooco; Randi Ulberg; Björn Philips Journal: J Med Internet Res Date: 2020-03-30 Impact factor: 5.428