Psychodynamic Therapy and Cognitive-Behavioral Therapy in Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

Ruhr-Universität Bochum, Bochum, North Rhine-Westphalia, Germany
American Journal of Psychiatry (Impact Factor: 12.3). 05/2013; 170(7). DOI: 10.1176/appi.ajp.2013.12081125
Source: PubMed


OBJECTIVE Various approaches to cognitive-behavioral therapy (CBT) have been shown to be effective for social anxiety disorder. For psychodynamic therapy, evidence for efficacy in this disorder is scant. The authors tested the efficacy of psychodynamic therapy and CBT in social anxiety disorder in a multicenter randomized controlled trial. METHOD In an outpatient setting, 495 patients with social anxiety disorder were randomly assigned to manual-guided CBT (N=209), manual-guided psychodynamic therapy (N=207), or a waiting list condition (N=79). Assessments were made at baseline and at end of treatment. Primary outcome measures were rates of remission and response, based on the Liebowitz Social Anxiety Scale applied by raters blind to group assignment. Several secondary measures were assessed as well. RESULTS Remission rates in the CBT, psychodynamic therapy, and waiting list groups were 36%, 26%, and 9%, respectively. Response rates were 60%, 52%, and 15%, respectively. CBT and psychodynamic therapy were significantly superior to waiting list for both remission and response. CBT was significantly superior to psychodynamic therapy for remission but not for response. Between-group effect sizes for remission and response were small. Secondary outcome measures showed significant differences in favor of CBT for measures of social phobia and interpersonal problems, but not for depression. CONCLUSIONS CBT and psychodynamic therapy were both efficacious in treating social anxiety disorder, but there were significant differences in favor of CBT. For CBT, the response rate was comparable to rates reported in Swedish and German studies in recent years. For psychodynamic therapy, the response rate was comparable to rates reported for pharmacotherapy and cognitive-behavioral group therapy.

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Available from: Viktoria Ritter, Mar 28, 2014
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    • "quality of object relations and interpersonal problems, reflecting quality and extent of characteristic behavior patterns (Vinnars et al., 2009), and defense mechanisms (Bond and Perry, 2004; Perry and Bond, 2012). Instead, comparisons between various short-term therapies have mostly found no significant differences across different outcome domains for patients with depressive and anxiety disorder (Abbass et al., 2011; Cuijpers et al., 2010; Driessen et al., 2013; Salzer et al., 2011; Slavin-Mulford and Hilsenroth, 2011), albeit some studies have shown lesser (Leichsenring et al., 2013b; Watzke et al., 2012) and some greater (Kallestad et al., 2010) effects in different aspects of personality functioning after short-term psychodynamic therapy in comparison to other therapies. As far as the authors know, there are only two randomized controlled trials that have compared the effectiveness of shortand long-term psychotherapy in patients with anxiety or depressive disorders on personality functioning, the Helsinki Psychotherapy Study (HPS, Knekt and Lindfors, 2004; Lindfors et al., 2012), and the Norwegian group therapy trial by Lorentzen et al. (2013). "
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    Journal of Affective Disorders 03/2015; 173:31-38. DOI:10.1016/j.jad.2014.10.039 · 3.38 Impact Factor
    • "The main study of the SOPHO-NET was a large multi-centre randomized controlled trial evaluating the efficacy of manualized cognitivebehavioural psychotherapy and psychodynamic psychotherapy compared to waiting list. The results of the efficacy trial have been published elsewhere (Leichsenring et al., 2013). For this analysis we used baseline data collected prior to the intervention. "
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    • "The trial is part of the Social Phobia Psychotherapy Research Network (SOPHO-NET) [15]. Design and results of the trial have been reported elsewhere [16]. "
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