Abstract
predict CBGT outcome resulted in inconclusive results. The present study examined the impact of depression on CBGT for social phobia (SP) in a naturalistic outpatient setting, in generalized (GSP) and specific SP (SSP) patients, upon completion and at 1-year follow-up. Methods: Consecutive SP outpatients (N=219), were diagnosed using a structured interview. CBGT was provided in 18 1.5-hour weekly sessions. At preand posttreatment questionnaires and clinician ratings were collected. Self-report measures were obtained at 1-year follow-up. The main outcome measure was the Liebowitz Social Anxiety Scale (LSAS). Results: CBGT was found to be effective in reducing both social anxiety (ES=1.23) as well as depression (ES=0.94). Individuals with GSP (GSPs) and individuals with SSP (SSPs) differed in their presenting psychopathology and in their response to CBGT. Among treatment completers, 44% GSPs and 37% SSPs achieved at least 50% improvement and 44% GSPs and 87% SSPs reported distress and functioning within the normal range. During the follow-up period SP symptoms aggravated in SP patients with initial MDD, while SP patients without baseline MDD experienced a further alleviation of their SP symptoms. Conclusions: 1. CBGTprovided in a public clinic to nonselected, mostly unmedicated, and comorbid patients, is an effective treatment for the majority of SP sufferers. 2. SP-associate MDD does respond to CBGT for SP and does not hamper immediate benefit on SP. 3. However, current MDD predicts later exacerbation of SP symptoms following treatment termination. 4. Therefore, depressed SPs may need additional intervention to maintain their CBGT gains. 5. SP with depression and without depression are probably two different subgroups.
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