A randomized controlled trial of cognitive behavior therapy as an adjunct to usualcare for social anxiety disorder refractory to initial SSRI treatment - CBT for SAD refractory to SSRI- Effectiveness of CBT adjunct usual care

This study aimed to examine the effectiveness of cognitive behavioral therapy (CBT) as an adjunct to usual care (UC) when compared to UC alone in SAD patients who remain symptomatic following antidepressant treatment. Patients were randomly allocated to CBT + UC (n=21) or UC-alone (n=21) group. After 16 weeks, the mean reduction in the Liebowitz Social Anxiety Scale from baseline for CBT + UC and UC-alone was -40.87 and 0.68, respectively; between-group difference was -41.55 (-53.68 to -29.42, p<0.0001). Response rates were 85.7% and 10.0% for CBT + UC and UC-alone, respectively (p<0.0001); the corresponding remission rates were 47.6% and 0.0%, respectively (p=0.0005). Significant differences were also found in favor of CBT + UC for social anxiety symptoms, depressive symptoms, and functional impairment. Our results suggest that in SAD patients who have been ineffectively-treated with antidepressant, CBT is an effective treatment adjunct to UC over 16 weeks in reducing social anxiety and related symptoms.