Heimberg R G, Liebowitz M R, Hope D A, Schneier F R, Holt C S, Welkowitz L A, Juster H R, Campeas R, Bruch M A, Cloitre M, Fallon B, Klein D F
Center for Stress and Anxiety Disorders, State University of New York at Albany, USA.
Arch Gen Psychiatry. 1998 Dec;55(12):1133-41. doi: 10.1001/archpsyc.55.12.1133.
This article presents results of the acute treatment phase of a 2-site study comparing cognitive behavioral group therapy (CBGT) and treatment with the monoamine oxidase inhibitor phenelzine sulfate for social phobia.
One hundred thirty-three patients from 2 sites received 12 weeks of CBGT, phenelzine therapy, pill placebo administration, or educational-supportive group therapy (an attention-placebo treatment of equal credibility to CBGT). The "allegiance effect," ie, the tendency for treatments to seem most efficacious in settings of similar theoretical orientation and less efficacious in theoretically divergent settings, was also examined by comparing responses to the treatment conditions at both sites: 1 known for pharmacological treatment of anxiety disorders and the other for cognitive behavioral treatment.
After 12 weeks, phenelzine therapy and CBGT led to superior response rates and greater change on dimensional measures than did either control condition. However, response to phenelzine therapy was more evident after 6 weeks, and phenelzine therapy was also superior to CBGT after 12 weeks on some measures. There were few differences between sites, suggesting that these treatments can be efficacious at facilities with differing theoretical allegiances.
After 12 weeks, both phenelzine therapy and CBGT were associated with marked positive response. Although phenelzine therapy was superior to CBGT on some measures, both were more efficacious than the control conditions. More extended cognitive behavioral treatment and the combination of modalities may enhance treatment effect.
本文介绍了一项在两个地点开展的研究中急性治疗阶段的结果，该研究比较了认知行为团体治疗（CBGT）和使用单胺氧化酶抑制剂硫酸苯乙肼治疗社交恐惧症的效果。
来自两个地点的133名患者接受了为期12周的CBGT、苯乙肼治疗、丸剂安慰剂给药或教育支持性团体治疗（一种与CBGT可信度相同的注意力安慰剂治疗）。通过比较两个地点对治疗条件的反应，还研究了“忠诚效应”，即治疗在理论取向相似的环境中似乎最有效，而在理论不同的环境中效果较差的趋势：一个地点以焦虑症的药物治疗而闻名，另一个地点以认知行为治疗而闻名。
12周后，与两种对照条件相比，苯乙肼治疗和CBGT导致了更高的缓解率和维度测量上更大的变化。苯乙肼治疗在6周后的反应更为明显，并且在12周后的一些测量中，苯乙肼治疗也优于CBGT。两个地点之间几乎没有差异，这表明这些治疗在具有不同理论倾向的机构中可能有效。
12周后，苯乙肼治疗和CBGT均与明显的积极反应相关。虽然苯乙肼治疗在某些测量上优于CBGT，但两者都比对照条件更有效。更长期的认知行为治疗和多种方式的联合可能会增强治疗效果。
