Background
Methods
Patients
Treatment
Assessment
Short Form 36 (SF-36)
Social Phobia Scale and Social Interaction Anxiety (SPS/SIAS)
Symptom Checklist-90-Revised (SCL-90-R)
Statistical analysis
Changes in symptoms and QoL through the treatment and follow-ups
Correlation between changes in SAD symptomatology and those in QoL
Potential predictors at baseline for changes in QoL at follow-ups
Results
Demographic and clinical characteristics of the patients
Patients who entered the CBT but did not complete | Patients who completed the CBT but not the 3-month FU assessments | Patients who completed the the 3-month but not the 12-month FU assessments | Patients who provided both FU assessments | P value | |
---|---|---|---|---|---|
Number of subjects | 9 | 4 | 4 | 40 | |
Female, No. (%)
| 3 (33.3) | 2 (50.0) | 2 (50.0) | 23 (57.5) | 0.63 |
Age, years
| |||||
Mean ± SD
| 27.4 ± 8.8 | 34.2 ± 9.3 | 34.2 ± 9.3 | 34.2 ± 8.9 | 0.12 |
Range
| 18-47 | 18-52 | 18-52 | 18-52 | |
Onset of SAD, years
| |||||
Mean ± SD
| 17.1 ± 4.2 | 19.4 ± 7.8 | 19.4 ± 7.8 | 19.6 ± 7.8 | 0.12 |
Range
| 12-23 | 5-42 | 5-42 | 5-42 | |
Living situation, No (%)
| 0.03* | ||||
With spouse/significant-other
| 0 (0.0) | 1 (25.0) | 2 (50.0) | 20 (50.0) | |
With parents
| 5 (55.6) | 3 (75.0) | 2 (50.0) | 16 (40.0) | |
Alone
| 4 (44.4) | 0 (0.0) | 0 (0.0) | 4 (10.0) | |
Employment
| 0.61 | ||||
Full-time employment
| 2 (22.2) | 1 (25.0) | 1 (25.0) | 10 (25.0) | |
Full-time student
| 2 (22.2) | 0 (0.0) | 0 (0.0) | 2 (5.0) | |
Part-time/homemaker/retired
| 3 (33.3) | 2 (50.0) | 3 (75.0) | 23 (55.0) | |
Unemployed
| 2 (22.2) | 1 (25.0) | 0 (0.0) | 6 (15.0) | |
Education, No. (%)
| 0.61 | ||||
University
| 2 (22.2) | 1 (25.0) | 1 (25.0) | 15 (37.5) | |
College
| 1 (11.1) | 3 (75.0) | 1 (25.0) | 10 (25.0) | |
High school or less
| 6 (66.6) | 0 (0.0) | 2 (50.0) | 15 (37.5) | |
Social phobia, No. (%) generalized
| 8 (88.8) | 4 (100.0) | 3 (75.0) | 34 (85.0) | 0.72 |
Comorbidity, No. (%)
| |||||
Mood disorders
| 2 (22.2) | 4 (100.0) | 2 (50.0) | 14 (35.0) | 0.05 |
Anxiety disorders
| 1 (11.1) | 1 (25.0) | 0 (0.0) | 4 (10.0) | 0.71 |
Medication, No. (%)
| |||||
Benzodiazepine
| 4 (44.4) | 0 (0.0) | 1 (25.0) | 11 (27.5) | 0.20 |
Antidepressant
| 7 (77.8) | 2 (50.0) | 2 (50.0) | 20 (50.0) | 0.50 |
SF-36
| |||||
Physical functioning
| 85.6 ± 14.7 | 91.3 ± 11.8 | 82.5 ± 22.2 | 88.6 ± 14.3 | 0.79 |
Role-physical
| 75.0 ± 43.3 | 62.5 ± 43.3 | 56.3 ± 51.5 | 68.6 ± 36.6 | 0.87 |
Bodily pain
| 90.3 ± 19.4 | 64.3 ± 29.4 | 66.5 ± 32.5 | 65.8 ± 25.3 | 0.08 |
General health perception
| 47.2 ± 22.4 | 49.8 ± 26.3 | 44.3 ± 26.3 | 45.1 ± 22.1 | 0.98 |
Vitality
| 42.2 ± 23.6 | 45.0 ± 5.8 | 20.0 ± 18.3 | 39.6 ± 21.1 | 0.28 |
Social functioning
| 45.8 ± 23.4 | 56.3 ± 21.7 | 65.6 ± 38.7 | 58.7 ± 30.2 | 0.63 |
Role-emotional
| 51.9 ± 44.4 | 50.0 ± 43.0 | 41.7 ± 50.0 | 57.3 ± 40.4 | 0.89 |
Mental health
| 44.9 ± 14.9 | 48.0 ± 3.3 | 36.0 ± 15.0 | 47.9 ± 20.5 | 0.67 |
SPS (total)
| 44.0 ± 13.7 | 47.3 ± 28.0 | 34.0 ± 6.2 | 33.7 ± 12.5 | 0.08 |
SIAS (total)
| 55.3 ± 9.8 | 64.5 ± 26.4 | 51.3 ± 11.2 | 51.0 ± 13.3 | 0.29 |
SCL-90-R depression
| 1.67 ± 0.96 | 1.52 ± 0.75 | 1.35 ± 0.89 | 1.50 ± 0.87 | 0.93 |
Changes in symptoms and QoL through the treatment and follow-ups
Pre-treatment | Post-treatment | 3-month FU | 12-month FU | ||
---|---|---|---|---|---|
Number of the patients | 57 | 48 | 44 | 40 | |
SF-36
| |||||
Physical functioning
|
Score
| 87.9 (14.5) | 89.8 (14.5) | 89.3 (15.4) | 90.6 (14.8) |
ES
| 0.10 (-0.32, 0.51) | 0.02 (-0.41, 0.46) | 0.15 (-0.30, 0.59) | ||
Role-physical
|
Score
| 68.3 (38.3) | 72.8 (34.5) | 78.0 (35.0) | 81.9 (31.5)* |
ES
| 0.06 (-0.36, 0.48) | 0.27 (-0.17, 0.70) | 0.39 (-0.06, 0.84) | ||
Bodily pain
|
Score
| 69.7 (26.1) | 70.8 (21.8) | 75.1 (23.9)* | 67.3 (24.6) |
ES
| 0.24 (-0.19, 0.65) | 0.32 (-0.12, 0.75) | 0.12 (-0.32, 0.57) | ||
General health perception
|
Score
| 45.7 (22.1) | 53.2 (22.3)* | 54.3 (24.7)* | 55.1 (24.4)* |
ES
| 0.28 (-0.14, 0.70) | 0.35 (-0.09, 0.78) | 0.44 (-0.02, 0.89) | ||
Vitality
|
Score
| 39.0 (21.0) | 49.2 (17.8)** | 46.5 (24.6)** | 45.3 (22.4)* |
ES
| 0.51 (0.08, 0.93) | 0.36 (-0.08, 0.79) | 0.29 (-0.17, 0.74) | ||
Social functioning
|
Score
| 56.9 (29.1) | 68.6 (29.6)* | 67.3 (28.9) | 66.3 (26.6) |
ES
| 0.30 (-0.12, 0.72) | 0.26 (-0.17, 0.70) | 0.28 (-0.17, 0.72) | ||
Role-emotional
|
Score
| 54.8 (40.9) | 61.5 (43.8) | 67.5 (38.4) | 60.8 (43.3) |
ES
| 0.07 (-0.35, 0.49) | 0.31 (-0.13, 0.75) | 0.08 (-0.36, 0.52) | ||
Mental health
|
Score
| 46.6 (18.6) | 54.4 (16.6)* | 55.4 (21.3)* | 54.7 (23.9)* |
ES
| 0.39 (-0.04, 0.81) | 0.40 (-0.04, 0.83) | 0.32 (-0.13, 0.77) | ||
SPS (total)
|
Score
| 36.3 (14.2) | 24.9 (14.8)** | 20.4 (11.0)** | 21.8 (12.7)** |
ES
| -0.69 (-1.10, -0.28) | -1.14 (-1.59, -0.68) | -0.96 (-1.41, -0.50) | ||
SIAS (total)
|
Score
| 52.7 (13.9) | 41.4 (15.6)** | 37.8 (13.1)** | 38.4 (15.5)** |
ES
| -0.71 (-1.12, -0.29) | -1.00 (-1.44, -0.54) | -0.87 (-1.32, -0.41) | ||
SCL-90-R depression
|
Score
| 1.52 (0.86) | 0.96 (0.75)** | 1.08 (0.86)** | 1.09 (0.97)** |
ES
| -0.66 (-1.07, -0.24) | -0.44 (-0.86, -0.01) | -0.45 (-0.89, 0.00) |
Correlation between changes in SAD symptomatology and those in QoL
Post-treatment | 3-month follow-up | 12-month follow-up | |||||||
---|---|---|---|---|---|---|---|---|---|
Number of the patients | 48 | 44 | 40 | ||||||
SPS | SIAS | SCL-90-R Depression | SPS | SIAS | SCL-90-R Depression | SPS | SIAS | SCL-90-R Depression | |
SF-36
| |||||||||
Physical functioning
| -0.32* | -0.19 | -0.33* | -0.23 | -0.18 | -0.27 | -0.09 | -0.03 | -0.05 |
Role-physical
| -0.13 | -0.16 | -0.12 | -0.31* | -0.22 | -0.33* | -0.12 | -0.02 | -0.10 |
Bodily pain
| -0.30 | -0.17 | -0.05 | -0.51** | -0.46** | -0.31 | -0.11 | -0.19 | 0.07 |
General health perception
| -0.43** | -0.41* | -0.33* | -0.53** | -0.47** | -0.47** | -0.28 | -0.26 | -0.31 |
Vitality
| -0.16 | -0.34* | -0.44** | -0.56** | -0.64** | -0.36* | -0.43* | -0.58** | -0.36* |
Social functioning
| -0.22 | -0.35* | -0.41* | -0.37* | -0.27 | -0.48** | -0.44* | -0.17 | -0.26 |
Role-emotional
| -0.45** | -0.36* | -0.41* | -0.28 | -0.36* | -0.14 | -0.24 | -0.33* | -0.22 |
Mental health
| -0.42* | -0.53** | -0.53** | -0.52** | -0.62** | -0.50** | -0.44* | -0.54** | -0.45* |
Potential predictors at baseline for changes in QoL at follow-ups
Characteristics | Post treatment | 3-month follow-up | 12-month follow-up | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
at baseline | PF | RP | BP | GH | VT | SF | RE | MH | PF | RP | BP | GH | VT | SF | RE | MH | PF | RP | BP | GH | VT | SF | RE | MH |
Adjusted R-square | 0.62 | 0.12 | 0.17 | 0.39 | 0.50 | 0.27 | 0.15 | 0.41 | 0.45 | 0.25 | 0.23 | 0.47 | 0.59 | 0.36 | 0.19 | 0.32 | 0.64 | 0.21 | 0.33 | 0.29 | 0.46 | 0.55 | 0.35 | 0.37 |
Age: 35 yrs or older
| a | a | a | a | a | a | 0.41* | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a |
Living situation
| a | a | a | a | -0.32** | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a |
Employment
| a | a | a | a | a | a | a | a | a | a | a | a | -0.30* | a | a | a | a | a | a | a | a | a | a | a |
Generalized SAD
| -0.22* | a | a | a | a | a | a | -0.28* | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a |
Benzodiazepine use
| 0.23* | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a |
SPS (total)
| a | a | a | a | a | a | a | a | a | 0.39* | a | 0.29* | a | a | a | a | a | a | a | a | a | 0.49** | a | a |
SIAS (total)
| a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | a | -0.32* | a | a |
SCL-90-R depression
| a | a | -0.44** | a | a | a | a | a | a | -0.64** | a | a | a | a | -0.46** | a | a | a | a | a | a | -0.41* | -0.61** | a |