School of Psychological Sciences, University of Haifa, Haifa, Israel.
Cogn Behav Ther. 2022 May;51(3):185-216. doi: 10.1080/16506073.2021.1966089. Epub 2021 Oct 7.
Social anxiety disorder (SAD) is highly comorbid with depression. In the present meta-analysis, we conducted the first individual-level examination of the association between pre-treatment depression and improvement in social anxiety symptoms during treatment. We identified eligible studies on cognitive behavior therapy (CBT) and pharmacotherapy for SAD and contacted authors to obtain individual-level data. We obtained these data from 41 studies, including 46 treatment conditions (n = 4,381). Our results showed that individuals who had high levels of depression at pre-treatment experienced greater decreases in social anxiety symptoms from pre- to post-treatment, but not at follow-up. When analyzing treatment modalities (individual CBT, group CBT, internet-delivered CBT, and pharmacotherapy), we found that depressive symptoms were associated with better post-treatment outcomes for individual CBT and internet-delivered CBT, but not for pharmacotherapy or group CBT. Our findings suggest that depression does not negatively affect treatment outcome in SAD and may even lead to improved outcomes in some treatment formats. Clinical implications of these findings are discussed.
社交焦虑障碍（SAD）与抑郁高度共病。在本荟萃分析中，我们首次在个体水平上检查了治疗前抑郁与治疗期间社交焦虑症状改善之间的关系。我们确定了针对 SAD 的认知行为疗法（CBT）和药物治疗的合格研究，并联系作者以获取个体水平的数据。我们从 41 项研究中获得了这些数据，其中包括 46 种治疗条件（n=4381）。我们的结果表明，治疗前抑郁程度较高的个体在治疗前至治疗后期间，社交焦虑症状的减轻幅度更大，但在随访时则没有。当分析治疗方式（个体 CBT、团体 CBT、互联网 CBT 和药物治疗）时，我们发现抑郁症状与个体 CBT 和互联网 CBT 的治疗后结果更好相关，但与药物治疗或团体 CBT 无关。我们的研究结果表明，抑郁不会对 SAD 的治疗结果产生负面影响，甚至可能在某些治疗形式中导致更好的结果。讨论了这些发现的临床意义。
