Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-15T07:42:20.227Z Has data issue: false hasContentIssue false
  • English
  • Français

WCA Recommendations for the Long-Term Treatment of Social Phobia

Published online by Cambridge University Press:  07 November 2014

Michael Van Ameringen ,
Christer Allgulander ,
Borwin Bandelow ,
John H. Greist ,
Eric Hollander ,
Stuart A. Montgomery ,
David J. Nutt ,
Ahmed Okasha ,
Mark H. Pollack  and
Dan J. Stein
...Show all authors
Get access Rights & Permissions [Opens in a new window]

Abstract

What is the best approach for treating patients with social phobia (social anxiety disorder) over the long term? Social phobia is the most common anxiety disorder, with reported prevalence rates of up to 18.7%. Social phobia is characterized by a marked and persistent fear of being observed or evaluated by others in social performance or interaction situations and is associated with physical, cognitive, and behavioral (ie, avoidance) symptoms. The onset of social phobia typically occurs in childhood or adolescence and the clinical course, if left untreated, is usually chronic, unremitting, and associated with significant functional impairment. Social phobia exhibits a high degree of comorbidity with other psychiatric disorders, including mood disorders, anxiety disorders, and substance abuse/dependence. Few people with social phobia seek professional help despite the existence of beneficial treatment approaches. The efficacy, tolerability, and safety of the selective serotonin reuptake inhibitors (SSRIs), evidenced in randomized clinical trials, support these agents as first-line treatment. The benzodiazepine clonazepam and certain monoamine oxidase inhibitors (representing both reversible and nonreversible inhibitors) may also be of benefit. Treatment of social phobia may need to be continued for several months to consolidate response and achieve full remission. The SSRIs have shown benefit in longterm treatment trials, while long-term treatment data from clinical studies of clonazepam are limited but support the drug's efficacy. There is also evidence for the effectiveness of exposure-based strategies of cognitive-behavioral therapy, and controlled studies suggest that the effects of treatment are generally maintained at long-term follow-up. In light of the chronicity and disability associated with social phobia, as well as the high relapse rate after short-term therapy, it is recommended that effective treatment be continued for at least 12 months.

Type
Academic Supplement
Information
CNS Spectrums , Volume 8 , supplement S1: Recommendations for the Long-Term Treatment of Anxiety Disorders , August 2003 , pp. 40 - 52
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Stein, MB, Torgrud, LJ, Walker, JR. Social phobia symptoms, subtypes, and severity: findings from a community survey. Arch Gen Psychiatry. 2000;57:1046–1052.CrossRefGoogle ScholarPubMed
2.Kessler, RC, Stang, P, Wittchen, HU, Stein, M, Walters, EE. Lifetime comorbidities between social phobia and mood disorders in the US National Comorbidity Survey. Psychol Med. 1999;29:555–567.CrossRefGoogle ScholarPubMed
3.Wittchen, HU, Stein, MB, Kessler, RC. Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychol Med. 1999;29:309–323.CrossRefGoogle Scholar
4.Katzelnick, DJ, Greist, JH. Social anxiety disorder: an unrecognized problem in primary care. J Clin Psychiatry. 2001;62(suppl 1):11–15.Google ScholarPubMed
5.Ballenger, JC, Davidson, JR, Lecrubier, Y, et al.Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry. 2001;62(suppl 13):47–55.Google Scholar
6.Magee, WJ, Eaton, WW, Wittchen, HU, McGonagle, KA, Kessler, RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry. 1996;53:159–168.CrossRefGoogle ScholarPubMed
7.Stein, MB, Walker, JR, Forde, DR. Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety. Am J Psychiatry. 1994;151:408–412.Google ScholarPubMed
8.Essau, CA, Conradt, J, Petermann, F. [Frequency and comorbidity of social anxiety and social phobia in adolescents. Results of a Bremen adolescent study.] Fortschr Neurol Psychiatr. 1998;66:524–530. GermanCrossRefGoogle ScholarPubMed
9.Kilts, CD, Gross, R, Newport, J, et al.A functional neuroimaging study of social anxiety and its treatment. Int J Neuropsychopharmacol. 2000;3:S290.Google Scholar
10.Kessler, RC. The epidemiology, natural history, and pharmacoeconomics of social anxiety and PTSD. Eur Neuropsychopharmacol. 2000;10:S185–S186.CrossRefGoogle Scholar
11.Lecrubier, Y, Weiller, E. Comorbidities in social phobia. Int Clin Psychopharmacol. 1997;12(suppl 6):S17–S21.CrossRefGoogle ScholarPubMed
12.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
13.The International Classification of Diseases. 10th revision. Geneva, Switzerland: World Health Organization; 1992.Google Scholar
14.Burke, KC, Burke, JD, Regier, DA, Rae, DS. Age at onset of selected mental disorders in five community populations. Arch Gen Psychiatry. 1990;47:511–518.CrossRefGoogle ScholarPubMed
15.Lopez-Ibor, JJ, Ayuso Gutierrez, JL. Social phobia: a debilitating disease that needs treatment. Int Clin Psychopharmacol. 1997;12(suppl 6):S11–S16.CrossRefGoogle ScholarPubMed
16.Ballenger, JC, Davidson, JR, Lecmbier, Y, et al.Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry. 1998;59(suppl 17):54–60.Google Scholar
17.Brunello, N, den Boer, JA, Judd, LL, et al.Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment. J Affect Disord. 2000;60:61–74.CrossRefGoogle ScholarPubMed
18.Bech, P, Angst, J. Quality of life in anxiety and social phobia. Int Clin Psychopharmacol. 1996;11(suppl 3):97–100.CrossRefGoogle ScholarPubMed
19.Wittchen, HU, Beloch, E. The impact of social phobia on quality of life. Int Clin Psychopharmacol. 1996;11(suppl 3):15–23.CrossRefGoogle ScholarPubMed
20.Wittchen, HU. Disability associated with social anxiety disorder. Eur Neuropsychopharmacol. 1999;9:S313.Google Scholar
21.Schneier, FR, Johnson, J, Homig, CD, Liebowitz, MR, Weissman, MM. Social phobia, comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry. 1992;49:282–288.CrossRefGoogle Scholar
22.Kessler, RC, Stein, MB, Berglund, P. Social phobia subtypes in the National Comorbidity Survey. Am J Psychiatry. 1998;155:613–619.CrossRefGoogle ScholarPubMed
23.Mennin, DS, Fresco, DM, Heimberg, RG, Schneier, FR, Davies, SO, Liebowitz, MR. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16:661–673.CrossRefGoogle ScholarPubMed
24.Norton, GR, McLeod, L, Guertin, J, Hewitt, PL, Walker, JR, Stein, MB. Panic disorder or social phobia: which is worse? Behav Res Ther. 1996;34:273–276.CrossRefGoogle ScholarPubMed
25.Reich, J, Noyes, R, Yates W Anxiety symptoms distinguishing social phobia from panic and generalized anxiety disorders. J Nerv Ment Dis. 1988;176:510–513.CrossRefGoogle ScholarPubMed
26.Kinrys, G, Bostwick, JM. Pharmacological dissection of panic disorder and social phobia: using valproic acid as a clinical tool. Int J Neuropsychopharmacol. 2000;3:S289–S290.Google Scholar
27.Amies, PL, Gelder, MG, Shaw, PM. Social phobia: a comparative clinical study. Br J Psychiatry. 1983;142:174–179.CrossRefGoogle ScholarPubMed
28.Moutier, CY, Stein, MB. The history, epidemiology, and differential diagnosis of social anxiety disorder. J Clin Psychiatry. 1999;60(suppl 9):4–8.Google ScholarPubMed
29.Stein, DJ. Diagnostic dilemmas in social anxiety disorder and posttraumatic stress. Eur Neuropsychopharmacol. 2000;10:S186–187.CrossRefGoogle Scholar
30.Black, B, Uhde, TW. Elective mutism as a variant of social phobia. J Am Acod Child Adolesc Psychiatry. 1992;31:1090–1094.CrossRefGoogle ScholarPubMed
31.Kleinknecht, RA, Dinnel, DL, Kleinknecht, EE, Hiruma, N, Harada, N. Cultural factors in social anxiety: a comparison of social phobia symptoms and Taijin kyofusho. J Anxiety Disord. 1997; 11:157–177.CrossRefGoogle ScholarPubMed
32.Kirmayer, LJ. The place of culture in psychiatric nosology: Taijin kyofusho and DSM-III-R. J Nerv Ment Dis. 1991;179:19–28.CrossRefGoogle ScholarPubMed
33.Stein, MB, Chavira, DA. Subtypes of social phobia and comorbidity with depression and other anxiety disorders. J Affect Disord. 1998;50(suppl 1):S11–S16.CrossRefGoogle ScholarPubMed
34.Stein, MB. Coming face-to-face with social phobia. Am Fam Physician. 1999;60:2244–2247.Google ScholarPubMed
35.Kessler, RC, McGonagle, KA, Zhao, S, et al.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle ScholarPubMed
36.Wittchen, HU, Nelson, CB, Lachner, G. Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol Med. 1998;28:109–126.CrossRefGoogle ScholarPubMed
37.Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
38.Heimberg, RG, Stein, MB, Hiripi, E, Kessler, RC. Trends in the prevalence of social phobia in the United States: a synthetic cohort analysis of changes over four decades. Eur Psychiatry. 2000;15:29–37.CrossRefGoogle ScholarPubMed
39.Wittchen, HU, Fehm, L. Epidemiology, patterns of comorbidity, and associated disabilities of social phobia. Psychiatr Clin North Am. 2001;24:617–641.CrossRefGoogle ScholarPubMed
40.Kessler, RC. Anxiety, mood, and substance abuse disorders: patterns and correlates of comorbidity. Eur Neuropsychopharmacol. 1999;9:S142–S144.CrossRefGoogle Scholar
41.Stein, MB, Chartier, MJ, Hazen, AL, et al.A direct-interview family study of generalized social phobia. Am J Psychiatry. 1998;155:90–97.CrossRefGoogle ScholarPubMed
42.Katzelnick, DJ, Kobak, KA, DeLeire, T, et al.Impact of generalized social anxiety disorder in managed care. Am J Psychiatry 2001;158:1999–2007.CrossRefGoogle ScholarPubMed
43.Katzelnick, DJ, Kobak, KA, Helstad, CP, et al. The direct and indirect costs of social phobia in managed care patients. Paper presented at: 19th Annual Conference of the Anxiety Disorders Association of America; March 1999; San Diego, Calif.Google Scholar
44.Westenberg, HG. Neurobiology of anxiety disorders: focus on neuroimaging. Eur Neuropsychopharmacol. 2000;10:S189.CrossRefGoogle Scholar
45.Ameringen, MV, Mancini, C, Farvolden, P, Oakman, J. Drugs in development for social anxiety disorder: more to social anxiety than meets the SSRI. Expert Opin Invesrig Drugs. 2000;9:2215–2231.CrossRefGoogle ScholarPubMed
46.Van Ameringen, M, Mancini, C, Farvolden, P, et al.The neurobiology of social phobia: from pharmacotherapy to brain imaging. Curr Psychiatry Rep. 2000;2:358–366.CrossRefGoogle ScholarPubMed
47.Nutt, DJ, Bell, CJ, Malizia, AL. Brain mechanisms of social anxiety disorder. J Clin Psychiatry. 1998;59(suppl 17):4–11.Google ScholarPubMed
48.van der Linden, GJ, van Heerden, B, Warwick, J, et al.Functional brain imaging and pharmacotherapy in social phobia: single photon emission computed tomography before and after treatment with the selective serotonin reuptake inhibitor citalopram. Prog Neuropsychopharmacol Biol Psychiatry. 2000;24:419–438.CrossRefGoogle ScholarPubMed
49.den Boer, JA, Bosker, FJ, Slaap, BR. Neurobiology of social anxiety disorder. Eur Neuropsychopharmacol. 1999;9:S165.CrossRefGoogle Scholar
50.Schneier, FR, Liebowitz, MR, Abi-Dargham, A, Zea-Ponce, Y, Lin, SH, Laruelle, M. Low dopamine D(2) receptor binding potential in social phobia. Am J Psychiatry. 2000;157:457–459.CrossRefGoogle ScholarPubMed
51.Stein, MB, Tancer, ME, Gelernter, CS, Vittone, BJ, Uhde, TW. Major depression in patients with social phobia. Am J Psychiatry. 1990;147:637–639.Google ScholarPubMed
52.van Ameringen, M, Mancini, C, Styan, G, Donison, D. Relationship of social phobia with other psychiatric illness. J Affect Disord. 1991;21:93–99.CrossRefGoogle ScholarPubMed
53.Lepine, JP, Pelissolo, A. Social phobia and alcoholism: a complex relationship. J Affect Disord. 1998;50(suppl 1):S23–S28.CrossRefGoogle ScholarPubMed
54.Wittchen, HU. Nicotine consumption in mental disorders: a clinical epidemiological perspective. Eur Neuropsychopharmacol. 2000; 10:S119.CrossRefGoogle Scholar
55.Nascimento, I, Nardi, AE, Valenca, AM, et al.Cigarette smoking and anxiety disorders. Int J Neuropsychopharmacol. 2000;3:S284.Google Scholar
56.Liebowitz, MR. Social phobia. In: Klein, D, ed. Modern Problems of Pharmacopsychiatry: Anxiety. Basel, Switzerland: Karger; 1987;141–173.Google Scholar
57.Davidson, JR, Potts, NL, Richichi, EA, et al.The Brief Social Phobia Scale. J Clin Psychiatry. 1991;52(suppl):48–51.Google ScholarPubMed
58.Davidson, JR, Miner, CM, de Veaugh-Geiss, J, Tupler, LA, Colket, JT, Potts, NL. The Brief Social Phobia Scale: a psychometric evaluation. Psychol Med. 1997;27:161–166.CrossRefGoogle Scholar
59.Marks, IM, Mathews, AM. Brief standard self-rating for phobic patients. Behav Res Ther. 1979;17:263–267.CrossRefGoogle ScholarPubMed
60.Cattalani, M, Faraone, SV, Tsuang, MT. The year in psychiatry. Praxis Post. January 24, 2001.Google Scholar
61.Katzelnick, DJ, Kobak, KA, Greist, JH, Jefferson, JW, mantle, JM, Serlin, RC. Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry. 1995;152:1368–1371.Google ScholarPubMed
62.Mancini, C, van Ameringen, M. Paroxetine in social phobia. J Clin Psychiatry. 1996;57:519–522.CrossRefGoogle ScholarPubMed
63.Stein, MB, Chartier, MJ, Hazen, AL, et al.Paroxetine in the treatment of generalized social phobia: open-label treatment and double-blind placebo-controlled discontinuation. J Clin Psychopharmacol. 1996;16:218–222.CrossRefGoogle ScholarPubMed
64.Stein, MB, Liebowitz, MR, Lydiard, RB, Pitts, CD, Bushnell, W, Gergel, I. Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial. JAMA. 1998;280:708–713.CrossRefGoogle ScholarPubMed
65.Allgulander, C. Paroxetine in social anxiety disorder: a randomized placebo-controlled study. Acta Psychiatr Scand. 1999;100:193–198.CrossRefGoogle ScholarPubMed
66.Baldwin, D, Bobes, J, Stein, DJ, Scharwachter, I, Faure, M. Paroxetine in social phobia/social anxiety disorder. Randomised, double-blind, placebo-controlled study. Paroxetine Study Group. Br J Psychiatry. 1999;175:120–126.CrossRefGoogle ScholarPubMed
67.Lydiard, RB, Bobes, J. Therapeutic advances: paroxetine for the treatment of social anxiety disorder. Depress Anxiety. 2000;11:99–104.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
68.van Ameringen, M, Lane, RM, Walker, JR, et al.Sertraline treatment of generalized social phobia: a 20-week, double-blind, placebo-controlled study. Am J Psychiatry. 2001;158:275–281.CrossRefGoogle ScholarPubMed
69.Liebowitz, MR, DeMartinis, N, Weihs, KL, Chung, H, Fayyad, R, Clary, CM. Results from a randomized, double-blind, multicenter trial of sertraline in the treatment of moderate-to-severe social phobia (social anxiety disorder). Poster presented at: 40th Annual Meeting of the American College of Neuropsychopharmacology; December 9–13, 2001; Waikaloa, Hawaii.CrossRefGoogle Scholar
70.Blomhoff, S, Haug, TT, Hellstrom, K, et al.Randomised control general practice trial of sertraline, exposure and combined treatment in generalised social phobia. Br J Psychiatry. 2001;179:23–30.CrossRefGoogle Scholar
71.van Vliet, IM, den Boer, JA, Westenberg, HG. Psychopharmacological treatment of social phobia; a double blind placebo controlled study with fluvoxamine. Psychopharmacobgy (Berl). 1994;115:128–134.CrossRefGoogle ScholarPubMed
72.Stein, MB, Fyer, AJ, Davidson, JR, Pollack, MH, Wiita, B. Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study. Am J Psychiatry. 1999;156:756–760.CrossRefGoogle ScholarPubMed
73.Lepola, U, Koponen, H, Leinonen, E. Citalopram in the treatment of social phobia: a report of three cases. Pharmacopsychiaay. 1994;27:186–188.CrossRefGoogle ScholarPubMed
74.Varia, IM, Cloutier, CA, Doraiswamy, PM. Treatment of social anxiety disorder with citalopram. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:205–208.CrossRefGoogle ScholarPubMed
75.Bouwer, C, Stein, DJ. Use of the selective serotonin reuptake inhibitor citalopram in the treatment of generalized social phobia. J Affect Disord. 1998;49:79–82.CrossRefGoogle ScholarPubMed
76.van Ameringen, M, Mancini, C, Streiner, DL. Fluoxetine efficacy in social phobia. J Clin Psychiatry. 1993;54:27–32.Google ScholarPubMed
77.Fairbanks, JM, Pine, DS, Tancer, NK, et al.Open fluoxetine treatment of mixed anxiety disorders in children and adolescents. J Child Adolesc Psychopharmacol. 1997;7:17–29.CrossRefGoogle ScholarPubMed
78.Pallanti, S, Quercioli, L, Rossi, A, Pazzagli, A. The emergence of social phobia during clozapine treatment and its response to fluoxetine augmentation. J Clin Psychiatry. 1999;60:819–823.CrossRefGoogle ScholarPubMed
79.van der Linden, GJ, Stein, DJ, van Balkom, AJ. The efficacy of the selective serotonin reuptake inhibitors for social anxiety disorder (social phobia): a meta-analysis of randomized controlled trials. Int Clin Psychopharmacol. 2000;15(suppl 2):S15–S23.CrossRefGoogle ScholarPubMed
80.The International Multicenter Clinical Trial Group on Moclobemide in Social Phobia. Moclobemide in social phobia: a double-blind, placebo-controlled clinical study. Eur Arch Psychiatry Clin Neurosci. 1997;247:71–80.CrossRefGoogle Scholar
81.Versiani, M, Nardi, AE, Mundim, FD, Alves, AB, Liebowitz, MR, Amrein, R. Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry. 1992;161:353–360.CrossRefGoogle ScholarPubMed
82.Noyes, R, Moroz, G, Davidson, JR, et al.Moclobemide in social phobia: a controlled dose-response trial. J Clin Psychopharmacol. 1997; 17:247–254.CrossRefGoogle ScholarPubMed
83.Schneier, FR, Goetz, D, Campeas, R, Fallon, B, Marshall, R, Liebowitz, MR. Placebo-controlled trial of moclobemide in social phobia. Br J Psychiatry. 1998;172:70–77.CrossRefGoogle ScholarPubMed
84.Versiani, M, Nardi, AE, Mundim, FD, Pinto, S, Saboya, E, Kovacs, R. The long-term treatment of social phobia with moclobemide. Int Clin Psychopharmacol. 1996;11(suppl 3):83–88.CrossRefGoogle ScholarPubMed
85.Diagnostic and Statistical Manual of Mental Disorders. 3rd ed rev. American Psychiatric Association; 1980.Google Scholar
86.van Vliet, IM, den Boer, JA, Westenberg, HG. Psychopharmacological treatment of social phobia: clinical and biochemical effects of brofaromine, a selective MAO-A inhibitor. Eur Neuropsychopharmacol 1992;2:21–29.CrossRefGoogle ScholarPubMed
87.Fahlen, T, Nilsson, HL, Borg, K, Humble, M, Pauli, U. Social phobia: the clinical efficacy and tolerability of the monoamine oxidase-A and serotonin uptake inhibitor brofaromine: a double-blind placebo controlled study. Acta Psychiatr Scand 1995;92:351–358.CrossRefGoogle ScholarPubMed
88.Heimberg, RG, Liebowitz, MR, Hope, DA, et al.Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome. Arch Gen Psychiatry. 1998;55:1133–1141.CrossRefGoogle ScholarPubMed
89.Liebowitz, MR, Schneier, F, Campeas, R, et al.Phenelzine vs atenolol in social phobia. A placebo-controlled comparison. Arch Gen Psychiatry. 1992;49:290–300.CrossRefGoogle ScholarPubMed
90.Versiani, M, Mundim, FD, Nardi, AE, Liebowitz, MR. Tranylcypromine in social phobia. J Clin Psychopharmacol. 1988;8:279–283.CrossRefGoogle ScholarPubMed
91.Sareen, L, Stein, M. A review of the epidemiology and approaches to the treatment of social anxiety disorder. Drugs. 2000;59:497–509.CrossRefGoogle Scholar
92.Liebowitz, MR, Gorman, J, Fyer, A, et al.Psychopharmacological treatment of social phobia. Psychopharmacol Bull. 1985;21:610–614.Google ScholarPubMed
93.Liebowitz, MR, Fyer, AJ, Gorman, JM, Campeas, R, Levin, A. Phenelzine in social phobia. J Clin Psychopharmacol. 1986;6:93–98.CrossRefGoogle ScholarPubMed
94.Gelernter, CS, Uhde, TW, Cimbolic, P, et al.Cognitive-behavioral and pharmacological treatments of social phobia: a controlled study. Arch Gen Psychiatry. 1991;48:938–945.CrossRefGoogle ScholarPubMed
95.Liebowitz, MR, Gorman, JM, Fyer, AJ, et al.Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol. J Clin Psychiatry. 1988;49:252–257.Google ScholarPubMed
96.Liebowitz, MR, Schneier, F, Campeas, R, et al.Phenelzine and atenolol in social phobia. Psychopharmacol Bull. 1990;26:123–125.Google ScholarPubMed
97.Munjack, DJ, Baltazar, PL, Bohn, PB, Cabe, DD, Appleton, AA. Clonazepam in the treatment of social phobia: a pilot study. J Clin Psychiatry. 1990;51(suppl):35–40.Google ScholarPubMed
98.Davidson, JR, Potts, N, Richichi, E, et al.Treatment of social phobia with clonazepam and placebo. J Clin Psychopharmacol. 1993;13:423–428.CrossRefGoogle ScholarPubMed
99.Connor, KM, Davidson, JR, Potts, NL, et al.Discontinuation of clonazepam in the treatment of social phobia. J Clin Psychopharmacol. 1998;18:373–378.CrossRefGoogle ScholarPubMed
100.Sutherland, SM, Tupler, LA, Colket, JT, Davidson, JR. A 2-year followup of social phobia. Status after a brief medication trial. J Nerv Ment Dis. 1996;184:731–738.CrossRefGoogle ScholarPubMed
101.Simpson, HB, Schneier, FR, Campeas, RB, et al.Imipramine in the treatment of social phobia. J Clin Psychopharmacol. 1998;18:132–135.CrossRefGoogle ScholarPubMed
102.Altamura, AC, Pioli, R, Vitto, M, Mannu, P. Venlafaxine in social phobia: a study in selective serotonin reuptake inhibitor non-responders. Int Clin Psychopharmacol. 1999; 14:239–245.CrossRefGoogle ScholarPubMed
103.Ninan, PT. Use of venlafaxine in other psychiatric disorders. Depress Anxiety. 2000;12(suppl 1):90–94.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
104.Van Ameringen, M, Mancini, C, Oakman, JM. Nefazodone in social phobia. J Clin Psychiatry. 1999;60:96–100.CrossRefGoogle ScholarPubMed
105.van Vliet, IM, van Veen, F, Westenberg, HG. Mirtazapine in social anxiety disorder. Int J Neuropsychopharmacol. 2000;3:S283.Google Scholar
106.Baldwin, D. Comprehensive treatment of social anxiety disorder. Eur Neuropsychopharmacol. 2000;10:S187–S188.CrossRefGoogle Scholar
107.Turner, SM, Beidel, DC, Jacob, RG. Social phobia: a comparison of behavior therapy and atenolol. J Consult Clin Psychol. 1994;62:350–358.CrossRefGoogle ScholarPubMed
108.Falloon, IR, Lloyd, GG, Harpin, RE. The treatment of social phobia. Real-life rehearsal with nonprofessional therapists. J New Merit Dis. 1981;169:180–184.Google ScholarPubMed
109.van Vliet, IM, den Boer, JA, Westenberg, HG, Pian, KL. Clinical effects of buspirone in social phobia: a double-blind placebo-controlled study. J Clin Psychiatry. 1997;58:164–168.CrossRefGoogle ScholarPubMed
110.Schneier, FR, Saoud, JB, Campeas, R, et al.Buspirone in social phobia. J Clin Psychopharmacol. 1993; 13:251–256.CrossRefGoogle ScholarPubMed
111.Pande, AC, Davidson, JR, Jefferson, JW, et al.Treatment of social phobia with gabapentin: a placebo-controlled study. J Clin Psychopharmacol 1999;19:341–348.CrossRefGoogle ScholarPubMed
112.Feltner, DE, Pollack, MH, Davidson, JR, et al.A placebo-controlled study of pregabalin treatment of social phobia: outcome and predictors of response. Eur Neuropsychopharmacol. 2000; 10:S344–S345.CrossRefGoogle Scholar
113.Walker, JR, Van Ameringen, MA, Swinson, R, et al.Prevention of relapse in generalized social phobia: results of a 24-week study in responders to 20 weeks of sertraline treatment. J Clin Psychopharmacol. 2000;20:636–644.CrossRefGoogle ScholarPubMed
114.Hair, T, Castrogiovanni, P, Domenech, J, et al.Short-term efficacy of paroxetine in social anxiety disorder is maintained after long-term treatment. Int J Neuropsychopharmacol. 2000;3:S227.Google Scholar
115.Kumar, R, Pitts, C, Carpenter, D. Response to paroxetine is maintained during continued treatment in patients with social anxiety disorder. Eur Neuropsychopharmacol. 1999;9:S312–S313.CrossRefGoogle Scholar
116.Liebowitz, MR, Heimberg, RG, Schneier, FR, et al.Cognitive-behavioral group therapy versus phenelzine in social phobia: long-term outcome. Depress Anxiety. 1999;10:89–98.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
117.Heimberg, RG. Current status of psychotherapeutic interventions for social phobia. J Clin Psychiatry. 2001;62(suppl 1):36–42.Google ScholarPubMed
118.Haug, TT, Hellstrom, K, Blomhoff, S, Humble, M, Madsbu, HP, Wold, JE. The treatment of social phobia in general practice. Is exposure therapy feasible? Fam Pract. 2000;17:114–118.CrossRefGoogle Scholar
119.Antony, MM, Swinson, RP. Exposure-based strategies and social skills training. In: Antony, MM, Swinson, RP, eds. Phobic Disorders and Panic in Adults: A Guide to Assessment and Treatment. 1st ed. Washington, DC: American Psychological Association; 2000;191–238.Google Scholar
120.Hope, DA, Heimberg, RG, Bruch, MA. Dismantling cognitive-behavioral group therapy for social phobia. Behav Res Ther. 1995;33:637–650.CrossRefGoogle ScholarPubMed
121.Butler, G, Cullington, A, Munby, M, Amies, P, Gelder, M. Exposure and anxiety management in the treatment of social phobia. J Consult Clin Psychol. 1984;52:642–650.CrossRefGoogle ScholarPubMed
122.Mattick, RP, Peters, L. Treatment of severe social phobia: effects of guided exposure with and without cognitive restructuring. J Consult Clin Psychol. 1988;56:251–260.CrossRefGoogle ScholarPubMed
123.Cottraux, J, Note, I, Albuisson, E, et al.Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial. Psychother Psychosom. 2000;69:137–146.CrossRefGoogle ScholarPubMed
124.Haug, TT, Blomhoff, S, Hellstrom, K, et al.Exposure therapy and sertraline in social phobia: 1-year follow-up of a randomised controlled trial. Br J Psychiatry. 2003;182:312–318.CrossRefGoogle Scholar
125.Otto, MW, Pollack, MH, Gould, RA, Worthington, JJ 3rd, McArdle, ET, Rosenbaum, JF. A comparison of the efficacy of clonazepam and cognitive-behavioral group therapy for the treatment of social phobia. J Anxiety Disord 2000;14:345–358.CrossRefGoogle ScholarPubMed
126.Dandrifosse, AC, Ansseau, M. [Guidelines for the treatment of anxiety disorders in adults.] Rev Med Liege. 2000;55:400–408. FrenchGoogle ScholarPubMed
127.Ballenger, JC. Clinical guidelines for establishing remission in patients with depression and anxiety. J Ciin Psychiatry. 1999;60(suppl 22):29–34.Google ScholarPubMed