Cognitive Behavioral Group Therapy vs Phenelzine Therapy for Social Phobia

Heimberg, Richard G.; Liebowitz, Michael R.; Hope, Debra A.; Schneier, Franklin R.; Holt, Craig S.; Welkowitz, Lawrence A.; Juster, Harlan R.; Campeas, Raphael; Bruch, Monroe A.; Cloitre, Marylène; Fallon, Brian A.; Klein, Donald F.

doi:10.1001/archpsyc.55.12.1133

Cited by 524 publications

(375 citation statements)

References 58 publications

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“…The irreversible MAOI phenelzine was superior to placebo, atenolol and moclobemide (Heimberg et al 1998;Liebowitz et al 1988;Versiani et al 1992). Long-term efficacy was shown in a comparison of phenelzine and moclobemide; however, phenelzine was less well tolerated than moclobemide (Versiani et al 1992).…”

Section: Irreversible Monoamine Oxidase Inhibitors (Maois)mentioning

confidence: 99%

“…In one study comparing the efficacy of phenelzine and CBT, phenelzine was superior to CBT in the acute and maintenance treatment phase, but phenelzine patients showed a trend toward greater relapse during treatment-free follow-up (Heimberg et al 1998;Liebowitz et al 1999). In a second study of the same work group, which has not yet been published, phenelzine, CBT, and a combination of both were compared.…”

Section: )(E)mentioning

confidence: 99%

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World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: Irreversible Monoamine Oxidase Inhibitors (Maois)mentioning

confidence: 99%

Section: )(E)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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“…No primeiro 11 , a fenelzina demonstrou melhores resultados do que a TCC no pós-tes-te e no follow-up de 6 meses 12 . Os 133 pacientes com TAS avaliados receberam TCC em grupo, fenelzina, placebo ou terapia de suporte educacional em grupo.…”

Section: Resultsunclassified

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Mululo

Menezes

Fontenelle

et al. 2009

Rev. psiquiatr. Rio Gd. Sul

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ResumoObjetivo: Avaliar a efi cácia do tratamento cognitivo e/ou comportamental no transtorno de ansiedade social quando comparado a outras intervenções terapêuticas, incluindo farmacoterapia. Método: Realizamos análise sistemática de todos os ensaios clínicos controlados randomizados envolvendo terapia cognitiva e/ou comportamental versus outras formas de tratamento, publicados até março de 2009, indexados nas seguintes bases de dados: MEDLINE, PsycINFO, Registro Cochrane de Ensaios Controlados, LILACS e ISI/Web of Science. Resultados: Os estudos avaliados não demonstraram diferenças signifi cativas entre a terapia cognitiva e/ou comportamental e a farmacoterapia. Esses tratamentos combinados não apresentaram maior efi cácia do que as intervenções isoladamente. Quando comparada ao grupo controle, a terapia cognitiva e/ou comportamental é efi caz na redução dos sintomas de ansiedade social, tanto no seu formato padrão quanto nas novas formas de intervenção. A exceção foi o treino em habilidades sociais, que, isoladamente, não se mostrou efi caz. A terapia cognitiva e/ou comportamental também demonstrou ser superior aos outros tipos de psicoterapias. Conclusão: A terapia cognitiva e/ou comportamental mostrou-se efi caz na redução da ansiedade social em pacientes com transtorno de ansiedade social. No entanto, a heterogeneidade dos estudos avaliados, seja no que diz respeito a aspectos envolvendo o tratamento (duração do tratamento e protocolos utilizados) ou os pacientes avaliados (gravidade e forma de recrutamento), difi cultaram a comparação dos resultados. Novos estudos de tratamento cognitivo e/ou comportamental e novas revisões envolvendo essas abordagens são necessários para melhor avaliação de nossos achados. Descritores: Fobia social, terapia cognitiva, terapia comportamental, transtorno de ansiedade social, revisão. AbstractObjective: To ascertain whether cognitive and/or behavioral treatment of patients with social anxiety disorder is superior in terms of effi cacy than other types of therapeutic interventions, including pharmacotherapy. Method: 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 signifi cant differences in the effi cacy of cognitive and/or behavioral therapy and pharmacotherapy. Such treatments combined did not show higher effi cacy 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 pati...

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“…In terms of anxiety disorders, the work of Heimberg and his colleagues on social phobias usually has larger effect sizes (cf. Heimberg & Becker, 2002). Additionally, the only thing, including medications, that really works for OCD is exposure with response prevention (cf.…”

Section: Hypnosis and The Evidence Base For Evidence-based Psychothementioning

confidence: 99%

Two Cases, One Good Therapist

Karlin

2006

Pragmatic Case Studies in Psychotherapy

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In my view, the most important similarity between Betty and Lawrence is that they had the same therapist, not that they had similar problems (Hamburg, 2006). This view raises several issues. First, are there any aspects of what Dr. Hamburg does that might be problematic for a less experienced and talented therapist. The one thing that clearly falls in this category is his use of the videotape metaphor for discovering memories during hypnotic age regression. This metaphor has created difficulties in the past and might best be avoided.Second, Dr. Hamburg seems to rely more on personally invented procedures and clinical lore than on manualized, evidence-based techniques. In this paper, the evidence base for evidence-based procedures is examined in terms of what we know about effect sizes from research on clinical hypnosis. I suggest that the evidence base for most evidence-based procedures is, at best, weak.Third, I speculate briefly about the effects of training clinical psychology graduate students in cognitive-behavioral therapy (CBT) by having them serve as therapists in randomized control trials (RCTs). In contrast to my previously stated (relatively positive) views (Karlin, 2002), I suggest that such training may not aid them in becoming thoughtful, creative, flexible therapists like Dr. Hamburg.

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Cognitive Behavioral Group Therapy vs Phenelzine Therapy for Social Phobia

Abstract: Background: 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.

Cited by 524 publications

References 58 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Two Cases, One Good Therapist

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