Cognitive–behavioral therapy modifies the naturalistic course of social anxiety disorder: Findings from an ABA design study in routine clinical practices

Authors

  • Toshi A. Furukawa MD, PhD,

    Corresponding author
    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
    • Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto
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  • Yumi Nakano MD, PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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  • Tadashi Funayama MD, PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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  • Sei Ogawa MD, PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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  • Tetsuji Ietsugu PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
    2. Nagoya Keizai University Junior College, Inuyama, Japan
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  • Yumiko Noda PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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  • Junwen Chen PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
    2. School of Psychology, Flinders University, Adelaide, Australia
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  • Norio Watanabe MD, PhD,

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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  • Tatsuo Akechi MD, PhD

    1. Department of Psychiatry and Cognitive–Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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Correspondence: Toshi A. Furukawa, MD, PhD, Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto 601-8501, Japan. Email: furukawa@kuhp.kyoto-u.ac.jp

Abstract

Aims

While randomized evidence appears to have established efficacy of cognitive–behavioral therapy (CBT) and some pharmacotherapy for social anxiety disorder (SAD), their real-world effectiveness has been called into question by long-term naturalistic cohort studies of patients with SAD as they show very low probability of recovery and sustained social dysfunctions despite some drug and psychological therapies.

Method

The present study examines the effectiveness of group CBT for SAD in real-world settings (n = 62) by examining the course of patients' symptomatology and social functions through approximately 6 months on the waiting list, through 6 months receiving the manualized group CBT intervention consisting of 16 2-h sessions, and for 12 months after the treatment.

Results

We found: (i) that the patients with SAD changed little or possibly worsened through the 6 months on the waiting list, although two in three of them were on antidepressants, benzodiazepines or both; (ii) that both their symptomatology and social function improved significantly and substantively through the group CBT; and (iii) that this improvement was maintained through the 3- and 12-month follow ups.

Conclusions

We can implement and must disseminate evidence-based, effective CBT for more patients with SAD to lessen their suffering and stop the perpetuation of their symptoms.

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