Cognitive behavioral therapy (CBT) treats social anxiety disorder more effectively than antidepressants, according to a John Hopkins University study.
The researchers said that CBT focuses on relationships between thoughts, feelings and behaviors. It helps people encounter irrational fears and overcome their avoidance of social situations. The therapy has been found to have lasting effects even long after the treatment is over.
Social anxiety disorder, affecting up to 13 percent of Americans and Europeans, is a psychiatric condition characterized by intense fear and avoidance of social situations and. Medication is the most commonly used treatment due to shortage of trained psychotherapists.
"Social anxiety is more than just shyness," study leader Evan Mayo-Wilson, a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, said in a press release. "People with this disorder can experience severe impairment, from shunning friendships to turning down promotions 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."
For the study, the researchers analysed data from 13,164 participants in 101 clinical trials and compared multiple types of medication to talk therapy. All the participants had severe and longstanding social anxiety. In experiments, approximately 9,000 received medication or a placebo pill, and more than 4,000 were subjected to a psychological intervention.
The researchers found that individual CBT was more effective than a combination of therapy and medication or just anti-depressants alone.
However, for those who lack access to CBT or don't prefer them can choose antidepressants- selective serotonin reuptake inhibitors (SSRIs) - as a second-line therapy because the improvements in symptoms do not last long after patients stopped taking the pills. Plus, these medications carry the risk of serious adverse events.
"Greater INVESTMENT in psychological therapies would improve quality of life, increase workplace productivity, and reduce healthcare costs," Mayo-Wilson said. "The healthcare system does not treat mental health equitably, but meeting demand isn't simply a matter of getting insurers to pay for psychological services. We need to improve infrastructure to treat mental health problems as the evidence shows they should be treated. We need more programs to train clinicians, more experienced supervisors who can work with new practitioners, more offices, and more support staff."
The finding is published in the journal The Lancet Psychiatry.
