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Long-Term Outcome of Psychodynamic Therapy and Cognitive-Behavioral Therapy in Social Anxiety Disorder
Falk Leichsenring, D.Sc.; Simone Salzer, D.Sc.; Manfred E. Beutel, M.D.; Stephan Herpertz, M.D.; Wolfgang Hiller, Ph.D.; Juergen Hoyer, Ph.D.; Johannes Huesing, Dr.Rer.Medic.; Peter Joraschky, M.D.; Bjoern Nolting, M.D.; Karin Poehlmann, Ph.D.; Viktoria Ritter, D.Phil.Nat.; Ulrich Stangier, D.Sc.; Bernhard Strauss, Ph.D.; Susan Tefikow, Ph.D.; Tobias Teismann, Ph.D.; Ulrike Willutzki, Ph.D; Joerg Wiltink, M.D.; Eric Leibing, D.Sc.
Am J Psychiatry 2014;:. doi:10.1176/appi.ajp.2014.13111514
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From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig University Giessen, Giessen, Germany; the Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August University Göttingen, Göttingen, Germany; the Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; the Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Bochum, Germany; the Ruhr University Bochum, Bochum, Germany; the Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; the Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany; the Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; the Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; the Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; the Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; the Clinical Psychology and Psychotherapy, Ruhr University Bochum, Bochum, Germany.

Copyright © 2014 by the American Psychiatric Association

Received November 19, 2013; Revised March 12, 2014; Revised April 22, 2014; Accepted April 25, 2014.

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Abstract

Objective  Relatively few studies have examined the long-term outcome of psychotherapy in social anxiety disorder. The authors previously reported findings of a clinical trial comparing cognitive-behavioral therapy (CBT), psychodynamic therapy, and a wait-list control. The purpose of the present study was to follow the participants’ status over the ensuing 24 months.

Method  Outpatients with social anxiety disorder who were treated with CBT (N=209) or psychodynamic therapy (N=207) in the previous trial were assessed 6, 12, and 24 months after the end of therapy. Primary outcome measures were rates of remission and response.

Results  For both CBT and psychodynamic therapy, response rates were approximately 70% by the 2-year follow-up. Remission rates were nearly 40% for both treatment conditions. Rates of response and remission were stable or tended to increase for both treatments over the 24-month follow-up period, and no significant differences were found between the treatment conditions after 6 months.

Conclusions  CBT and psychodynamic therapy were efficacious in treating social anxiety disorder, in both the short- and long-term, when patients showed continuous improvement. Although in the short-term, intention-to-treat analyses yielded some statistically significant but small differences in favor of CBT in several outcome measures, no differences in outcome were found in the long-term.

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