Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder

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.