Cognitive Therapy vs Interpersonal Psychotherapy in Social Anxiety Disorder

1. Cognitive Therapy vs Interpersonal Psychotherapy in Social Anxiety Disorder Ulrich Stangier, PhD; Elisabeth Scharmm, PhD; ThmoasHeidenreich, PhD; Matthias Berger, MD; David M.Clark, DPhil

2. Social Anxiety Disorder • Social Anxiety Disorder (SAD) is a common mental disorder that is associated with considerable vocational and psychological handicap and an increased risk of comorbid disorders.

3. Design • Treatment comprised up to 16 individual sessions conducted mainly on a weekly basis. A booster session was offered 2 months after treatment. The WLC group received treatment after a 20 week waiting period. • The main assessment points were before treatment/wait, after treatment/wait, and 1 year after treatment completion.

4. Patients • Patients were recruited via the private practice of psychiatrists, outpatient clinics, and advertisements in local newspapers and on the internet. • Of the 697 individuals who contacted the study center, 254 were assed by interview, 137 were excluded owing to a failure to meet the inclusion criteria or for other reasons. Of 44 patients who refused to participate, 8 who met the inclusion criteria withdrew after signing the consent form but before randomization. The remaining 117 individuals met the inclusion criteria and were randomized.

6. Treatment • The treatment comprised of 16 individual sessions conducted over 20 weeks. • Patients on the waiting list received no treatment until the initial 20 weeks had concluded.

7. Cognitive Therapy • The cognitive therapy was based on the cognitive model of SAD of Clark and Wells and included six main components.

8. Interpersonal Psychotherapy • For SAD, Interpersonal Psychotherapy was based on a revised version of the standard manual developed by Lipsitz and Markowitz.

9. Assessment Procedures • The primary outcome measure was treatment response as assessed by the clinical global impression scale. • Independent assessors masked to the treatment conditions completed the 7-point rating scale at the post treatment and 1-year-follow-up. • The secondary outcome measures were independent assessor on the Liebowitz Social Anxiety Scale.

10. Description of the Sample

11. Primary Outcome • At the posttreatment/wait assessment 25 out of the 38 patients who had undergone cognitive therapy, 16 out of the 38 who had undergone Interpersonal Therapy, and 3 of the 41 on the waiting list were classified as responders.

12. Secondary Outcomes • At the posttreatment/wait assessment, the independent assessor ratings on the LSAS indicated that patients that received cognitive or interpersonal therapy showed greater improvement than those on the waiting list.

13. Results • At the posttreatment assessment, response rates were 65.8% for cognitive therapy, 42.1% for interpersonal therapy, and 7.3% for the waiting list group.