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A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder

Published online by Cambridge University Press:  16 April 2020

Daniela Z. Knijnik ,
Carlos Blanco ,
Giovanni Abrahão Salum ,
Carolina U. Moraes ,
Clarissa Mombach ,
Ellen Almeida ,
Marília Pereira ,
Atahualpa Strapasson ,
Gisele G. Manfro  and
Cláudio L. Eizirik
Daniela Z. Knijnik*
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Carlos Blanco
Affiliation:
Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY10032, USA
Giovanni Abrahão Salum
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Carolina U. Moraes
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Clarissa Mombach
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Ellen Almeida
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Marília Pereira
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Atahualpa Strapasson
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Gisele G. Manfro
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
Cláudio L. Eizirik
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil
*
*Corresponding author. Present address: Rua Hilário Ribeiro 202/503, CEP 90510-040, Porto Alegre, RS, Brazil. Tel./fax: +55 51 334 66902.E-mail address: [email protected] (D.Z. Knijnik), [email protected] (C. Blanco), [email protected] (G.A. Salum), [email protected] (C.U. Moraes), [email protected] (C. Mombach), [email protected] (E. Almeida), [email protected] (A. Strapasson), [email protected] (G.G. Manfro), [email protected] (C.L. Eizirik).
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Abstract

Background

Both psychodynamic group therapy (PGT) and clonazepam are used as treatment strategies in reducing symptoms of generalized social anxiety disorder (GSAD). However, many individuals remain symptomatic after treatment with PGT or clonazepam.

Method

Fifty-eight adult outpatients with a diagnosis of GSAD according to DSM-IV were randomized to 12 weeks PGT plus clonazepam or clonazepam. The Clinical Global Impression-Improvement (CGI-I) Scale was the primary efficacy measure. Secondary efficacy measures included the Liebowitz Social Anxiety Scale (LSAS) total score, the World Health Organization Instrument to Assess Quality of Life—Brief (WHOQOL-Bref) Scale and the Beck Depression Inventory (BDI).

Results

CGI-I data from 57 patients (intent-to-treat population) showed that patients who received PGT plus clonazepam presented significantly greater improvement than those who received clonazepam (P = 0.033). There were no significant differences between the two groups in the secondary efficacy measures.

Conclusions

Our study suggests that the combination of PGT with clonazepam may be a promising strategy for the treatment of GSAD, regarding gains in the global functioning. However the present study failed to detect more specific changes in social anxiety symptomatology between the two groups.

Keywords

Anxiety disordersSocial anxiety disorderSocial phobiaPsychodynamic therapyTreatmentAnxiolytics
Type
Original article
Information
European Psychiatry , Volume 23 , Issue 8 , December 2008 , pp. 567 - 574
Copyright
Copyright © Elsevier Masson SAS 2008

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