Responders and non-responders to drug treatment in social phobia: differences at baseline and prediction of response

Slaap, B.R.; Westenberg, H. G. M.; DenBoer, JA

doi:10.1016/0165-0327(96)00013-4

Cited by 24 publications

(14 citation statements)

References 23 publications

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“…For example, studies have focused on SAD subtype (e.g., Slaap, van Vilet, Westenberg, & Den Boer, 1996), age of onset (Van Ameringen et al, 2004), and duration of illness (D. Stein, Stein, Pitts, Kumar, & Hunter, 2002).…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapy for social anxiety disorder: Interpersonal predictors of outcome and the mediating role of the working alliance

Cohen

Drabick

Blanco

et al. 2017

Journal of Anxiety Disorders

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Social anxiety disorder (SAD) is highly prevalent and associated with high levels of impairment and distress. Therapies for SAD leave many patients symptomatic at the end of treatment, and little is known about predictors or mechanisms of treatment outcome. Given the interpersonal dysfunction fundamental to SAD, this study investigated whether prominent interpersonal features of SAD (submissive behavior, childhood maltreatment, suppression of anger, and depression) predicted attrition and response to pharmacotherapy and whether the working alliance mediated these relationships. This is the first study to examine the role of the working alliance in pharmacotherapy for SAD. One hundred thirty-eight treatment-seeking individuals with a primary diagnosis of SAD received 12 weeks of open treatment with paroxetine. Higher levels of depression predicted greater severity of SAD at the end of treatment, and higher levels of submissive behavior and childhood emotional maltreatment predicted a greater probability of attrition from treatment. The psychiatrist-assessed working alliance mediated response to pharmacotherapy for individuals who reported a history of emotional maltreatment. These results identify variables that predict pharmacotherapy outcome and emphasize the importance of the working alliance as a mechanism of treatment response for those with a history of emotional maltreatment. Implications for person-specific treatment selection are discussed.

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Section: Introductionmentioning

confidence: 99%

Pharmacotherapy for social anxiety disorder: Interpersonal predictors of outcome and the mediating role of the working alliance

Cohen

Drabick

Blanco

et al. 2017

Journal of Anxiety Disorders

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“…Slaap et al 15 reported that higher heart rate and blood pressure as well as elevated baseline measures of anxiety and depression appeared to predict nonresponse to treatment with fluvoxamine. In a retrospective analysis of a placebo-controlled study of paroxetine treatment in social phobia, Montgomery 16 found that greater baseline severity appeared to predict better response to paroxetine.…”

mentioning

confidence: 98%

Predictors of Response in Generalized Social Phobia

Ameringen

Oakman

Mancini

et al. 2004

Journal of Clinical Psychopharmacology

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Selective serotonin reuptake inhibitors (SSRIs) are the gold standard for the pharmacological treatment of generalized social phobia (GSP). However, little is known about the predictors of response to treatment. Two hundred and four outpatients with GSP were randomized to sertraline (Zoloft) or placebo, for a 20-week double-blind study, with a flexible dose range of sertraline 50 to 200 mg/d. Response was defined as the percentage of patients with a Clinical Global Impression-Improvement scale (CGI-I) of 1 (very much improved) or 2 (much improved). Outcome analyses were conducted using regression models including treatment group as a categorical predictor and study visit as a repeated measure. Dependent measures included Marks Fear Questionnaire (MFQ), Brief Social Phobia Scale (BSPS), CGI-I, and Sheehan Disability Scale (SDS). We investigated several possible predictors of response to treatment including DSM-IV comorbidity, age, sex, age of onset of GSP, and duration of illness. Patients with later-onset (especially adult-onset) GSP tend to have a better response to treatment than those with earlier-onset GSP. This result generally appears in our analyses as a 2-way interaction, where the association with response is greatest for patients with adult-onset GSP (in contrast to those with child or adolescent onset). This finding is most robust for symptom measures, but is still apparent for the Sheehan measure of disability at work. This advantage for later-onset GSP can be accounted for neither by severity of illness nor by duration of illness. Superior treatment outcome for later-onset GSP may be mediated by the degree of social and family disability.

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“…In the aforementioned study by Slaap et al [31], higher heart rate and blood pressure levels characterized nonresponders to fluvoxamine. This finding parallels observations in PD, and suggests that nonresponders with PD and SAD have a disturbed autonomous nervous system, although Stein et al [33] failed to replicate this finding in a sample of 829 patients with SAD.…”

Section: Neurochemical and Neurophysiologic Markersmentioning

confidence: 97%

“…Numerous treatment studies looked for predictors of response with SRIs. Slaap et al [31] showed that higher Hamilton Anxiety scale and HAM-D scores, and higher scores on the Symptom Checklist-90 (anxiety and interpersonal subscales) were indicative of nonresponse in a fluvoxamine and brofaromine comparison trial. In contrast, Montgomery [32] reported that patients with more severe SAD respond better to paroxetine treatment than do patients with moderate SAD.…”

Section: Demographic and Clinical Variablesmentioning

confidence: 98%

Predictors of pharmacotherapy response in anxiety disorders

Denys

Geus²

2005

Curr Psychiatry Rep

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Although treatment with different compounds such as tricyclic antidepressants, selective serotonin reuptake inhibitors, high-potency benzodiazepines, and monoamine oxidase inhibitors has been proven effective in anxiety disorders, 20% to 40% of patients are nonresponders. Given the limited efficacy, the delayed onset of response (it takes several weeks before a clinical effect can be seen for most of these drugs), and the occurrence of side effects associated with pharmacotherapy, predicting response in anxiety disorders would be immensely valuable. This review surveys the literature over the past years on predictors of response to pharmacotherapy in obsessive-compulsive disorder, social anxiety disorder, panic disorder, and posttraumatic stress disorder. Prediction of treatment response may be founded on demographic and clinical variables, neurochemical and electrophysiologic parameters, imaging studies, and genetic markers.

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Responders and non-responders to drug treatment in social phobia: differences at baseline and prediction of response

Cited by 24 publications

References 23 publications

Pharmacotherapy for social anxiety disorder: Interpersonal predictors of outcome and the mediating role of the working alliance

Pharmacotherapy for social anxiety disorder: Interpersonal predictors of outcome and the mediating role of the working alliance

Predictors of Response in Generalized Social Phobia

Predictors of pharmacotherapy response in anxiety disorders

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