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Combining escitalopram and cognitive–behavioural therapy for social anxiety disorder : randomised controlled fMRI trial
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- Gingnell, Malin (author)
- Uppsala universitet,Institutionen för psykologi,Uppsala University, Sweden
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- Frick, Andreas (author)
- Uppsala universitet,Institutionen för psykologi,Uppsala University, Sweden
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- Engman, Jonas (author)
- Uppsala universitet,Institutionen för psykologi,Uppsala University, Sweden
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- 2018-01-02
- 2016
- English.
- In: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 209:3, s. 229-235
- Journal article (peer-reviewed)
Abstract
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- BackgroundSelective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) are often used concomitantly to treat social anxiety disorder (SAD), but few studies have examined the effect of this combination.AimsTo evaluate whether adding escitalopram to internet-delivered CBT (ICBT) improves clinical outcome and alters brain reactivity and connectivity in SAD.MethodDouble-blind, randomised, placebo-controlled neuroimaging trial of ICBT combined either with escitalopram (n = 24) or placebo (n = 24), including a 15-month clinical follow-up (trial registration: ISRCTN24929928).ResultsEscitalopram+ICBT, relative to placebo+ICBT, resulted in significantly more clinical responders, larger reductions in anticipatory speech state anxiety at post-treatment and larger reductions in social anxiety symptom severity at 15-month follow-up and at a trend-level (P = 0.09) at post-treatment. Right amygdala reactivity to emotional faces also decreased more in the escitalopram+ICBT combination relative to placebo+ICBT, and in treatment responders relative to non-responders.ConclusionsAdding escitalopram improves the outcome of ICBT for SAD and decreased amygdala reactivity is important for anxiolytic treatment response.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- escitalopram
- cognitive-behavioural therapy
- CBT
- ICBT
- social anxiety disorder
- SAD
- fMRI
- Psychology
- psykologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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