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Stravynski A, Greenberg D.
"The treatment of social phobia: a critical assessment."
Acta psychiatrica Scandinavica. 1998 Sep;98(3):171-81.
This article critically reviews the effects of psychological treatment (exposure,
cognitive restructuring, social skills training) and pharmacological treatment (MAOIs,
reversible MAOIs, anxiolytics and SSRIs) of social phobia. Only controlled studies have
been included, and their outcomes were assessed for improvement in anxiety and
avoidance, social functioning and clinical status. Both psychological and
pharmacological treatments resulted in a significant and meaningful reduction in
anxiety and, in most cases, a weakening of the tendency to avoid. Although useful, the
effects were not of such a magnitude as to result in remission. Reduction in anxiety was
long-lasting in patients treated by psychological methods. The lessening of anxiety did
not necessarily lead to meaningfully improved social functioning. The combination of
psychological and pharmacological treatments was disappointing, and did not exceed
the effects of psychological treatments alone. However, the most promising medications
were not tested. Subtype of social phobia and additional diagnoses did not determine
the response to treatment.