INTRODUCTION: To ascertain whether cognitive and/or behavioral treatment of patients with social anxiety disorder is superior in terms of efficacy than other types of therapeutic interventions, including pharmacotherapy. METHODS: Systematic analysis of all randomized clinical trials on cognitive and/or behavioral therapy vs. other forms of treatment, published until March 2009, indexed in the following databases: MEDLINE, PsycINFO, Cochrane Controlled Trials Register, LILACS and ISI Web of Science. RESULTS: The reported results do not suggest significant differences in the efficacy of cognitive and/or behavioral therapy and pharmacotherapy. Such treatments combined did not show higher efficacy than interventions alone. Compared with the control group, cognitive and/or behavioral therapy was superior in reducing social anxiety disorder, either in the classic model or in the newest propositions. The only exception was the social skills training, which was not effective for patients with social anxiety disorder. Cognitive and/or behavioral therapy was also superior to other psychotherapeutic interventions. CONCLUSION: Cognitive and/or behavioral therapy is an effective treatment for patients with social anxiety disorder. However, the heterogeneity of the clinical trials evaluated, with reference to treatment features (time of treatment and different protocols) or characteristics of the patients (severity of their clinical picture and how they were recruited) made comparison of results between different treatments difficult. More research on cognitive and/or behavior treatment and new reviews of these interventions are necessary to better assess our findings.
Social phobia; cognitive therapy; behavior therapy; social anxiety disorder; review
