Psychiatria pre prax 4/2015

Therapeutic response to complex treatment in patients with social phobia

Introduction: In social phobia as well as other anxiety disorders is pharmacoresistancy an important problem. Exact predictors of the therapeutic response are not known yet. The aim of our study was to prove the efficacy of our treatment program and identify predictors of therapeutic response to complex pharmacotherapeutical and cognitive behavioral treatment in pharmacoresistant patients. Methods: We analysed data for 50 probands diagnosed with social phobia hospitalized on psychotherapeutical department of Department of Psychiatry, University Hospital Olomouc. We investigated basic demographic data (age, disease duration, age of onset), index of used antidepressant and scores of main raiting scales (LSAS, CGI, BAI, BDI, DES a DES-T). We also evaluated an influence of personality disorders. Results: There was a statisticly significant decease in symptomatology in all rating scales during the treatment. Change in LSAS (ratio of initial to last measured score) positively correlated only with age of onset of the disorder. Level of dissociation measured by DES correlated with initial BAI score, in case of DES-T with initial BAI and BDI. We proved statistically significant difference in intial BAI score when splitting to group to responders and non-responders by final CGI. There was no statistically significant result if we concentrate on influence of personality disorders. Conclusions: In our study we proved efficacy complex therapeutical program in treatment of pharmacoresistant patients with social phobia. Age of onset of disorder positively correlated with changes in LSAS during the treatment.

Keywords: social phobia, pharmacotherapy, CBT, complex treatment, therapeutic reaction, predictors.