Cognitive therapy for depressed adults with comorbid social phobia
Open accessAbstract
Background Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Methods Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. Results At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. Limitations The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. Conclusions These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.
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Other studies found that despite higher depression and SAD severity at pre- and post-treatment, rates of improvement did not differ.
“However, other studies have found that despite higher depression and SAD severity at pre- and post-treatment, rates of improvement have not differed (e.g., Erwin, Heimberg, Juster, & Mindlin, 2002; Marom, Gilboa-Schechtman, Aderka, Wiezman, & Hermesh, 2009; Smits, Minhajuddin, & Jarrett, 2009).”
From An Integrated, Acceptance-Based Behavioral Approach for Depression With Social Anxiety: Preliminary Results (2014) · cites this paper as Smits, Minhajuddin, & Jarrett, 2009
The Results (Rate of Improvement in Symptoms of Depression and Anxiety; page unavailable) report higher pretreatment self-reported depression and anxiety/arousal scores in patients with comorbid social phobia, but no significant difference in their rates of improvement. They also report no significant between-group differences on symptom measures at posttreatment, so higher posttreatment severity is not supported. The anxiety/arousal measure is not identified as a measure of SAD severity specifically. (LLM, conf=0.90)
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“(8) n’ont pas retrouvé de différence d’efficacité de la TCC en terme de taux de participation, de réponse et de rémission entre les patients souffrant d’une dépression comorbide d’une phobie sociale et les patients non comorbides.”
Background
- Authors
- Smits, J. A. J., Minhajuddin, A., & Jarrett, R. B.
- Affiliations
- Southern Methodist University (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Smits, Jasper A.J.
- Jarrett, Robin B.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 114
- Issue
- 1-3
- Pages
- 271-278
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC2677376
- OpenAlex
- W2082873219
- Cited by
- 33
- References
- 36
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Institute of Mental Health (MH38238, K02MH001571, R01MH075889, R01MH038238, MH075889, MH-01571)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive therapy, major depressive disorder, social anxiety disorder, comorbidities, social anxiety, treatment response, remission, attrition, depression severity, anxiety symptoms
- MeSH terms
- Adult, Anxiety, Depression, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Personality Inventory, Phobic Disorders, Psychiatric Status Rating Scales, Research Design, Severity of Illness Index, Time Factors, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders, Secondary Prevention
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