A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder.

Author(s): Knijnik DZ, Blanco C, Salum GA, Moraes CU, Mombach C, Almeida E, Pereira M, Strapasson A, Manfro GG, Eizirik CL

Affiliation(s): Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clinicas de Porto Alegre, Ramiro Barcellos 2350, room 400N, CEP 90035-003, Porto Alegre, RS, Brazil. knijnikd@terra.com.br

Publication date & source: 2008-12, Eur Psychiatry., 23(8):567-74. Epub 2008 Sep 6.

Publication type: Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

BACKGROUND: Both psychodynamic group therapy (PGT) and clonazepam are used as treatment strategies in reducing symptoms of generalized social anxiety disorder (GSAD). However, many individuals remain symptomatic after treatment with PGT or clonazepam. METHOD: Fifty-eight adult outpatients with a diagnosis of GSAD according to DSM-IV were randomized to 12 weeks PGT plus clonazepam or clonazepam. The Clinical Global Impression-Improvement (CGI-I) Scale was the primary efficacy measure. Secondary efficacy measures included the Liebowitz Social Anxiety Scale (LSAS) total score, the World Health Organization Instrument to Assess Quality of Life-Brief (WHOQOL-Bref) Scale and the Beck Depression Inventory (BDI). RESULTS: CGI-I data from 57 patients (intent-to-treat population) showed that patients who received PGT plus clonazepam presented significantly greater improvement than those who received clonazepam (P=0.033). There were no significant differences between the two groups in the secondary efficacy measures. CONCLUSIONS: Our study suggests that the combination of PGT with clonazepam may be a promising strategy for the treatment of GSAD, regarding gains in the global functioning. However the present study failed to detect more specific changes in social anxiety symptomatology between the two groups.