While antidepressants are the most commonly used treatment for social anxiety
disorder1, new research suggests that
cognitive2 behavioral therapy (CBT) is more effective and, unlike medication, can have
lasting3 effects long after treatment has stopped. Social anxiety disorder is a psychiatric condition characterized by intense fear and avoidance of social situations and affects up to 13 percent of Americans and Europeans. Most people never receive treatment for the disorder. For those who do, medication is the more accessible treatment because there is a shortage of trained psychotherapists.
The findings of the study, a network meta-analysis that collected and
analyzed4 data from 101 clinical trials comparing multiple types of medication and talk therapy, are published online Sept. 26 in The Lancet
Psychiatry5.
"Social anxiety is more than just shyness," says study leader Evan Mayo-Wilson, DPhil, a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. "People with this disorder can experience severe impairment, from
shunning6 friendships to turning down
promotions7 at work that would require increased social interaction. The good news from our study is that social anxiety is treatable. Now that we know what works best, we need to improve access to psychotherapy for those who are suffering."
The research was a
collaboration8 between the Johns Hopkins Bloomberg School of Public Health,
Oxford9 University and University College in London, where Mayo-Wilson
formerly10 worked.
For the study, Mayo-Wilson and his colleagues analyzed data from 13,164 participants in 101 clinical trials. The participants all had severe and longstanding social anxiety. Approximately 9,000 received medication or a
placebo11 pill, and more than 4,000 received a psychological
intervention12. Few of the trials looked at combining medication with talk therapy, and there was no evidence that combined therapy was better than talk therapy alone.
The data compared several different types of talk therapy and found individual CBT was the most effective. CBT is a form of treatment that focuses on relationships between thoughts, feelings and behaviors. It helps people challenge
irrational13 fears and overcome their avoidance of social situations, Mayo-Wilson says.