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Long-term outcome of social phobia treated by exposure

Published online by Cambridge University Press:  12 July 2001

G. A. FAVA ,
S. GRANDI ,
C. RAFANELLI ,
C. RUINI ,
S. CONTI  and
P. BELLUARDO
G. A. FAVA
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
S. GRANDI
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
C. RAFANELLI
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
C. RUINI
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
S. CONTI
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
P. BELLUARDO
Affiliation:
From the Department of Psychiatry, State University of New York at Buffalo; Affective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Bologna and Department of Statistical Sciences, University of Padova, Padova, Italy
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Abstract

Background. There is very little information on long-term follow-up of social phobia.

Methods. A consecutive series of 70 patients satisfying the DSM-IV criteria for social phobia was treated in an out-patient clinic with behavioural methods based on exposure homework. Forty-five patients were judged to be remitted after eight individual sessions of psychotherapy. A 2 to 12 year (median = 6 years) follow-up was performed. Survival analysis was selected to characterize the clinical course of patients. Assessments were performed before treatment, at the end of therapy, after 1 year, and subsequently on a yearly basis, and utilized selected items of Paykel's Clinical Interview for Depression.

Results. Six of the 45 patients (13%) had a relapse of social phobia at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 98 after 2 years, 85 after 5 years and 85 after 10 years. Such probabilities increased in the absence of a personality disorder, of residual social phobic avoidance after exposure, and of concurrent use of benzodiazepines.

Conclusions. The findings suggest that, even though one patient out of three is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting effects to the majority of patients with social phobia. Disappearance of residual, subclinical social phobic avoidance appears to be the target of treatment.

Type
Research Article
Information
Psychological Medicine , Volume 31 , Issue 5 , July 2001 , pp. 899 - 905
Copyright
© 2001 Cambridge University Press

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