Curtiss Joshua, Andrews Leigh, Davis Michelle, Smits Jasper, Hofmann Stefan G
a Department of Psychological and Brain Sciences , Boston University , Boston , USA.
b The University of Texas at Austin , Department of Psychology and Institute for Mental Health Research , Austin , USA.
Expert Opin Pharmacother. 2017 Feb;18(3):243-251. doi: 10.1080/14656566.2017.1285907. Epub 2017 Feb 1.
Social anxiety disorder (SAD) is among the most prevalent mental disorders, associated with impaired functioning and poor quality of life. Pharmacotherapy is the most widely utilized treatment option. The current study provides an updated meta-analytic review of the efficacy of pharmacotherapy and examines moderators and mediators of treatment efficacy. Areas Covered: A comprehensive search of the current literature yielded 52 randomized, pill placebo-controlled trials of pharmacotherapy for adults diagnosed with SAD. Data on potential mediators of treatment outcome were collected, as well as data necessary to calculate pooled correlation matrices to compute indirect effects. Expert Opinion: The overall effect size of pharmacotherapy for SAD is small to medium (Hedges' g = 0.41). Effect sizes were not moderated by age, sex, length of treatment, initial severity, risk of study bias, or publication year. Furthermore, reductions in symptoms mediated pharmacotherapy's effect on quality of life. Support was found for reverse mediation. Future directions may include sustained efforts to examine treatment mechanisms of pharmacotherapy using rigorous longitudinal methodology to better establish temporal precedence.
社交焦虑障碍（SAD）是最常见的精神障碍之一，与功能受损和生活质量差有关。药物治疗是应用最广泛的治疗选择。本研究对药物治疗的疗效进行了最新的荟萃分析综述，并探讨了治疗效果的调节因素和中介因素。涵盖领域：全面检索当前文献后，得到了52项针对被诊断为SAD的成年人进行药物治疗的随机、药丸安慰剂对照试验。收集了关于治疗结果潜在中介因素的数据，以及计算合并相关矩阵以计算间接效应所需的数据。专家意见：药物治疗SAD的总体效应大小为小到中等（Hedges' g = 0.41）。效应大小不受年龄、性别、治疗时长、初始严重程度、研究偏倚风险或发表年份的影响。此外，症状减轻介导了药物治疗对生活质量的影响。还发现了反向中介的证据。未来的方向可能包括持续努力，使用严格的纵向方法来研究药物治疗的机制，以更好地确定时间先后顺序。
