Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Change in quality of life and their predictors in the long-term follow-up after group cognitive behavioral therapy for social anxiety disorder: a prospective cohort study

Authors: Norio Watanabe, Toshi A Furukawa, Junwen Chen, Yoshihiro Kinoshita, Yumi Nakano, Sei Ogawa, Tadashi Funayama, Tetsuji Ietsugu, Yumiko Noda

Published in: BMC Psychiatry | Issue 1/2010

Login to get access

Abstract

Background

Social anxiety disorder (SAD) is one of the most common anxiety disorders. The efficacy of cognitive behaviour therapy (CBT) has been examined but to date its effects on Quality of Life (QoL) have not been appropriately evaluated especially in the long term.
The study aimed to examine, in the long term, what aspects of Quality of Life (QoL) changed among social anxiety disorder (SAD) patients treated with group cognitive behaviour therapy (CBT) and what predictors at baseline were associated with QoL.

Methods

Outpatients diagnosed with SAD were enrolled into group CBT, and assessed at follow-ups for up to 12 months in a typical clinical setting. QoL was evaluated using the Short Form 36. Various aspects of SAD symptomatology were also assessed. Each of the QoL domains and scores on symptomatology were quantified and compared with those at baseline. Baseline predictors of QoL outcomes at follow-up were investigated.

Results

Fifty-seven outpatients were enrolled into group CBT for SAD, 48 completed the whole program, and 44 and 40 completed assessments at the 3-month and 12-month follow-ups, respectively. All aspects of SAD symptomatology and psychological subscales of the QoL showed statistically significant improvement throughout follow-ups for up to 12 months. In terms of social functioning, no statistically significant improvement was observed at either follow-up point except for post-treatment. No consistently significant pre-treatment predictors were observed.

Conclusions

After group CBT, SAD symptomatology and some aspects of QoL improved and this improvement was maintained for up to 12 months, but the social functioning domain did not prove any significant change statistically. Considering the limited effects of CBT on QoL, especially for social functioning, more powerful treatments are needed.
Literature
1.
Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE: Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005, 62 (6): 617-627. 10.1001/archpsyc.62.6.617.CrossRefPubMedPubMedCentral
2.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005, 62 (6): 593-602. 10.1001/archpsyc.62.6.593.CrossRefPubMed
3.
Keller MB: The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatrica Scandinavica Supplementum. 2003 (417): 85-94.
4.
Kessler RC, Stang P, Wittchen HU, Stein M, Walters EE: Lifetime co-morbidities between social phobia and mood disorders in the US National Comorbidity Survey. Psychol Med. 1999, 29 (3): 555-567. 10.1017/S0033291799008375.CrossRefPubMed
5.
Beesdo K, Bittner A, Pine DS, Stein MB, Hofler M, Lieb R, Wittchen HU: Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry. 2007, 64 (8): 903-912. 10.1001/archpsyc.64.8.903.CrossRefPubMed
6.
Chartier MJ, Walker JR, Stein MB: Considering comorbidity in social phobia. Soc Psychiatry Psychiatr Epidemiol. 2003, 38 (12): 728-734. 10.1007/s00127-003-0720-6.CrossRefPubMed
7.
Wittchen HU, Fuetsch M, Sonntag H, Müller N, Liebowitz M: Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study. European Psychiatry. 2000, 15 (1): 46-58. 10.1016/S0924-9338(00)00211-X.CrossRefPubMed
8.
Stein MB, Kean YM: Disability and quality of life in social phobia: epidemiologic findings. The American Journal of Psychiatry. 2000, 157 (10): 1606-1613. 10.1176/appi.ajp.157.10.1606.CrossRefPubMed
9.
Dimenas ES, Dahlof CG, Jern SC, Wiklund IK: Defining quality of life in medicine. Scandinavian Journal of Primary Health Care Supplement. 1990, 1: 7-10.PubMed
10.
Rapaport MH, Clary C, Fayyad R, Endicott J: Quality-of-life impairment in depressive and anxiety disorders. The American Journal of Psychiatry. 2005, 162 (6): 1171-1178. 10.1176/appi.ajp.162.6.1171.CrossRefPubMed
11.
Barrera TL, Norton PJ: Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder. Journal of Anxiety Disorders. 2009, 23 (8): 1086-1090. 10.1016/j.janxdis.2009.07.011.CrossRefPubMedPubMedCentral
12.
Schneier FR: Clinical practice. Social anxiety disorder. The New England Journal of Medicine. 2006, 355 (10): 1029-1036. 10.1056/NEJMcp060145.CrossRefPubMed
13.
Hansen RA, Gaynes BN, Gartlehner G, Moore CG, Tiwari R, Lohr KN: Efficacy and tolerability of second-generation antidepressants in social anxiety disorder. Int Clin Psychopharmacol. 2008, 23 (3): 170-179. 10.1097/YIC.0b013e3282f4224a.CrossRefPubMedPubMedCentral
14.
Acarturk C, Cuijpers P, van Straten A, de Graaf R: Psychological treatment of social anxiety disorder: a meta-analysis. Psychol Med. 2009, 39 (2): 241-254. 10.1017/S0033291708003590.CrossRefPubMed
15.
Kasper S, Stein DJ, Loft H, Nil R: Escitalopram in the treatment of social anxiety disorder: randomised, placebo-controlled, flexible-dosage study. The British Journal of Psychiatry. 2005, 186: 222-226. 10.1192/bjp.186.3.222.CrossRefPubMed
16.
Stein MB, Fyer AJ, Davidson JR, Pollack MH, Wiita B: Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study. The American Journal of Psychiatry. 1999, 156 (5): 756-760.PubMed
17.
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 (8): 708-713. 10.1001/jama.280.8.708.CrossRefPubMed
18.
Cottraux J, Note I, Albuisson E, Yao SN, Note B, Mollard E, Bonasse F, Jalenques I, Guerin J, Coudert AJ: Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial. Psychotherapy and Psychosomatics. 2000, 69 (3): 137-146. 10.1159/000012382.CrossRefPubMed
19.
Mortberg E, Clark DM, Sundin O, Aberg Wistedt A: Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: a randomized controlled trial. Acta Psychiatrica Scandinavica. 2007, 115 (2): 142-154. 10.1111/j.1600-0447.2006.00839.x.CrossRefPubMed
20.
Haug TT, Blomhoff S, Hellstrom K, Holme I, Humble M, Madsbu HP, Wold JE: Exposure therapy and sertraline in social phobia: I-year follow-up of a randomised controlled trial. The British Journal of Psychiatry. 2003, 182: 312-318. 10.1192/bjp.182.4.312.CrossRefPubMed
21.
Andersson G, Carlbring P, Holmstrom A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Buhrman M, Ekselius L: Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology. 2006, 74 (4): 677-686. 10.1037/0022-006X.74.4.677.CrossRefPubMed
22.
Carlbring P, Gunnarsdottir M, Hedensjo L, Andersson G, Ekselius L, Furmark T: Treatment of social phobia: randomised trial of internet-delivered cognitive-behavioural therapy with telephone support. The British Journal of Psychiatry. 2007, 190: 123-128. 10.1192/bjp.bp.105.020107.CrossRefPubMed
23.
Aaronson NK, Bullinger M, Ahmedzai S: A modular approach to quality-of-life assessment in cancer clinical trials. Recent Results in Cancer Research, Fortschritte der Krebsforschung Progrès dans les Recherches sur le Cancer. 1988, 111: 231-249.PubMed
24.
Ghaedi GH, Tavoli A, Bakhtiari M, Melyani M, Sahragard M: Quality of life in college students with and without social phobia. Social Indicators Research. 2010, 97 (2): 247-256. 10.1007/s11205-009-9500-3.CrossRef
25.
McHorney CA, Ware JE, Lu JF, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care. 1994, 32 (1): 40-66. 10.1097/00005650-199401000-00004.CrossRefPubMed
26.
Liebowitz MR, Heimberg RG, Schneier FR, Hope DA, Davies S, Holt CS, Goetz D, Juster HR, Lin SH, Bruch MA, et al: Cognitive-behavioral group therapy versus phenelzine in social phobia: long-term outcome. Depression and Anxiety. 1999, 10 (3): 89-98. 10.1002/(SICI)1520-6394(1999)10:3<89::AID-DA1>3.0.CO;2-5.CrossRefPubMed
27.
Chen J, Nakano Y, Ietzugu T, Ogawa S, Funayama T, Watanabe N, Noda Y, Furukawa TA: Group cognitive behavior therapy for Japanese patients with social anxiety disorder: preliminary outcomes and their predictors. BMC Psychiatry. 2007, 7: 69-10.1186/1471-244X-7-69.CrossRefPubMedPubMedCentral
28.
First MB, Spitzer RL, Gibbon M, Williams JB: Structured Clinical Interview for DSM-IV axis I Diosrders. 1997, Washington, D. C.: American Psychiatric Press
29.
Andrews G, Creamer M, Crino R, Hunt C, Lampe L, Page A: The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals. 2002, Cambridge: Cambridge University Press, 2
30.
Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K: Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. Journal of Clinical Epidemiology. 1998, 51 (11): 1037-1044. 10.1016/S0895-4356(98)00095-X.CrossRefPubMed
31.
Mattick RP, Clarke JC: Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy. 1998, 36 (4): 455-470. 10.1016/S0005-7967(97)10031-6.CrossRefPubMed
32.
Kanai Y, Sasakawa S, Chen J, Suzuki S, Shimada H, Sakano Y: Development and validation of the Japanese version of Social Phobia Scale and Social Interaction Anxiety Scale. Shingshin-Igaku (Japanese Journal of Psychosomatic Medicine). 2004, 44: 841-850.
33.
Derogatis LR: SCL-90-R: Administration, Scoring and Procedures Manual-II for the Revised Version and Other Instruments of the Psychopathology Rating Scale Series. 1992, Towson: Clinical Psychometric Research, Inc.
34.
Furukawa T, Nakanishi M, Sakurai A, Suzuki Y, Suzuki-Moore A, Hamanaka T: Effects of ethyl loflazepate in mood and neurosisrelated disorders (ICD-10 JCM): Changes in SCL-90-R subscale scores. Rinsho Seishinigaku (Clinical Psychiatry). 1996, 25: 233-240.
35.
SPSS Japan Inc: SPSS 16.0. 2007, Tokyo, Japan: SPSS Japan Inc., 16.0
36.
Cohen J: Statistical power analysis in the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Erlbaum Assoc Inc.
37.
Safren SA, Heimberg RG, Brown EJ, Holle C: Quality of life in social phobia. Depression and Anxiety. 1996, 4 (3): 126-133. 10.1002/(SICI)1520-6394(1996)4:3<126::AID-DA5>3.0.CO;2-E.CrossRefPubMed
38.
Stein MB, Chavira DA: Subtypes of social phobia and comorbidity with depression and other anxiety disorders. Journal of Affective Disorders. 1998, 50 (Suppl 1): S11-16. 10.1016/S0165-0327(98)00092-5.CrossRefPubMed
39.
Simon NM, Otto MW, Korbly NB, Peters PM, Nicolaou DC, Pollack MH: Quality of life in social anxiety disorder compared with panic disorder and the general population. Psychiatric Services. 2002, 53 (6): 714-718. 10.1176/appi.ps.53.6.714.CrossRefPubMed
40.
Hollandsworth JG: Subjective well-being and behavior therapy: Challenge, opportunity, or dead end?. The Behavior Therapist. 1987, 10: 65-68.
41.
Eng W, Coles ME, Heimberg RG, Safren SA: Domains of life satisfaction in social anxiety disorder: relation to symptoms and response to cognitive-behavioral therapy. Journal of Anxiety Disorders. 2005, 19 (2): 143-156. 10.1016/j.janxdis.2004.01.007.CrossRefPubMed
42.
Clark DM, Ehlers A, Hackmann A, McManus F, Fennell M, Grey N, Waddington L, Wild J: Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial. J Consult Clin Psychol. 2006, 74 (3): 568-578. 10.1037/0022-006X.74.3.568.CrossRefPubMed
43.
Asakura S, Inoue S, Sasaki F, Sasaki Y, Kitagawa N, Inoue T, Denda K, Ito M, Matsubara R, Koyama T: Reliability and Validity of the Japanese Version of the Liebowitz Social Anxiety Scale. Seishin Igaku (Clinical Psychiatry). 2002, 44: 1077-1084.
44.
Baker SL, Heinrichs N, Kim HJ, Hofmann SG: The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behaviour Research and Therapy. 2002, 40 (6): 701-715. 10.1016/S0005-7967(01)00060-2.CrossRefPubMed
Metadata
Title
Change in quality of life and their predictors in the long-term follow-up after group cognitive behavioral therapy for social anxiety disorder: a prospective cohort study
Authors
Norio Watanabe
Toshi A Furukawa
Junwen Chen
Yoshihiro Kinoshita
Yumi Nakano
Sei Ogawa
Tadashi Funayama
Tetsuji Ietsugu
Yumiko Noda
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-81

Other articles of this Issue 1/2010

BMC Psychiatry 1/2010 Go to the issue

Research article

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries

Research article

Borna disease virus (BDV) circulating immunocomplex positivity in addicted patients in the Czech Republic: a prospective cohort analysis

Research article

The Beck Cognitive Insight Scale (BCIS): translation and validation of the Taiwanese version

Research article

Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study

Research article

Effectiveness of second-generation antipsychotics: a naturalistic, randomized comparison of olanzapine, quetiapine, risperidone, and ziprasidone

Study protocol

Study protocol: The development of a pilot study employing a randomised controlled design to investigate the feasibility and effects of a peer support program following discharge from a specialist first-episode psychosis treatment centre