Recent developments in research and treatment for social phobia (social anxiety disorder)

• Published in: Current opinion in psychiatry Vol. 18; no. 1; pp. 51 - 54
• Main Author: Cottraux, Jean
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-01-2005; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Anxiety; Fear & phobias; Medical research; Mental disorders; Society
• ISSN: 0951-7367; 1473-6578

PURPOSE OF REVIEWThis review covers three themes of research that brought fresh data useful for clinical practice in a handicapping anxiety disordersocial phobia. Recent findings deriving from basic biological research, new forms of psychological therapies, and recent psychopharmacology controlled trials are reviewed.
RECENT FINDINGSThe basic neuroimaging research suggests that greater activation of the amygdala to novel versus familiar faces may be an underlying trait marker for social phobia. Social phobia may represent a phenotype that expresses a genetically driven trait of social withdrawal, which may be related to infantile inhibited temperament (Kaganʼs syndrome). The development of virtual reality therapy as therapeutic tool for social phobia appeared promising in one controlled, but not randomized, study. A controlled study suggests that social phobias in children can be effectively treated with cognitive behavioural therapy. This represents an extension of the work done with adults. Venlafaxine appears an effective short-term treatment for social anxiety disorder in two controlled studies. A new compound, pregabalin, appeared clearly effective in a positive controlled study. This trial marks the advent of a new pharmacological lineage for social phobia. Both venlafaxine and pregabalin, however, have been studied in short-term studies. Longer follow-up and relapse prevention studies are warranted.
SUMMARYNeuroimaging research points to a temperamental basis for social phobia. Virtual reality therapy is an emerging tool to carry out exposure treatment. Group cognitive behavioural therapy can be extended successfully to children. Venlafaxine and pregabalin have a proven short-term effectiveness in social phobia.