Group cognitive-behavioral therapy, often recommended as first-line therapy for social anxiety disorder, is effective even when patients have comorbid major depressive or anxiety disorders, a recent report shows.
Few previous studies have examined whether coexisting depression or anxiety influence the outcome of psychological treatment for social anxiety, and their findings have been conflicting. In this study, researchers assessed pre- and posttreatment results on the Social Phobia Inventory and the Depression Anxiety Stress Scales for 163 adults treated with group CBT at a single community hospital outpatient clinic over a 10-year period. Forty-one of these participants had social anxiety disorder with no comorbid diagnoses, 76 had comorbid major depressive disorder, 19 had comorbid bipolar disorder, and 27 had additional comorbid anxiety disorders.
The average age of onset of social anxiety disorder was 12 years in the 77 men and 86 women. A total of 85% were white, said Katie Fracalanza, a doctoral student in the department of psychology, Ryerson University, Toronto, and her associates.
All patients showed significant improvement in social anxiety symptoms after treatment, regardless of their comorbidities. Also, small to moderate improvements were found in depressive symptoms, the investigators reported (J. Affect. Disord. 2014;162:61-6).
Patients with comorbid disorders presented with more severe symptoms than did those who only had social anxiety disorder, and they completed treatment with greater residual symptoms, though still significantly improved. Additional sessions might be helpful for further symptom remission in such patients, Ms. Fracalanza and her associates said.
Limitations of the study include the self-report nature of social anxiety and depressive symptoms, and the relatively small sample size. Nevertheless, these findings are in line with those of previous studies reporting that depressive symptoms "do not hinder the effectiveness of CBT for social anxiety disorder" and might improve even though they are not specifically targeted by the treatment, the investigators noted.