Van Ameringen M, Mancini C, Streiner D L
Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
J Clin Psychiatry. 1993 Jan;54(1):27-32.
To determine the efficacy of fluoxetine in the treatment of social phobia, fluoxetine was administered to 16 patients with a primary DSM-III-R diagnosis of social phobia in a 12-week, open, clinical trial.
Treatment began at 20 mg of fluoxetine daily and was increased according to clinical response and side effects every 4 weeks. Patients completed self-report measures of anxiety and depression at baseline and at Weeks 4, 8, and 12. These included the Beck Depression Inventory, the Social Avoidance and Distress Scale, the Fear of Negative Evaluation Scale, the State-Trait Anxiety Inventory, the Fear Questionnaire, the Social Anxiety Thoughts Questionnaire, and the Social Adjustment Scale-Self-Report. Clinicians completed a Clinical Global Improvement Scale.
Thirteen of the 16 patients completed the trial. Three patients (18.8%) were unable to complete the trial due to adverse side effects. Of the 13 (81.2%) remaining patients, 10 were considered to be responders and 3 were considered to be nonresponders. Measures of social anxiety and phobic avoidance showed a significant improvement from baseline to endpoint, achieving a significance of p < .005. Responders to fluoxetine were more likely to have been older at onset of the social phobic symptoms and had a shorter duration of illness.
These findings suggest that fluoxetine may be effective in the treatment of social phobia. Double-blind studies will be required to further investigate these findings.
为确定氟西汀治疗社交恐惧症的疗效,在一项为期12周的开放性临床试验中,对16例初步诊断为DSM-III-R社交恐惧症的患者给予氟西汀治疗。
治疗开始时每日服用20毫克氟西汀,并根据临床反应和副作用每4周增加剂量。患者在基线以及第4、8和12周完成焦虑和抑郁的自我报告测量。这些测量包括贝克抑郁量表、社交回避与苦恼量表、消极评价恐惧量表、状态-特质焦虑量表、恐惧问卷、社交焦虑思维问卷和社交适应量表-自我报告。临床医生完成临床整体改善量表。
16例患者中有13例完成了试验。3例患者(18.8%)因不良反应未能完成试验。在其余13例(81.2%)患者中,10例被视为有反应者,3例被视为无反应者。社交焦虑和恐惧回避测量从基线到终点显示出显著改善,p值<0.005。对氟西汀有反应的患者在社交恐惧症状出现时年龄较大且病程较短。
这些发现表明氟西汀可能对社交恐惧症有效。需要进行双盲研究以进一步调查这些发现。