Concomitant treatment with sertraline and social skills training improves social skills acquisition in social anxiety disorder: A double-blind, randomized controlled trial

Objectives To examine whether: (1) sertraline (SER) + psychotherapy is superior to psychotherapy alone; (2) group cognitive-behavioural therapy (GCBT) is superior to group psychodynamic therapy (GPT) and (3) SER+GCBT or SER+GPT is superior to Placebo (PLA)+GCBT or PLA+GPT in social anxiety disorder (SAD). Methods A double-blind randomized controlled trial. Participants were assigned either to: SER+GCBT (n = 34); SER+GPT (n = 36); PLA+GCBT (n = 36) or PLA+GPT (n = 41) for 20 weeks. SER (or PLA) was administered at doses from 50 to 200 mg/d. Primary measures were both categorial: remission (CGI score≤2), response of social symptoms (≥50% reduction in Scale of Avoidance and Social Discomfort (SASD)); and continuous: reduction of SASD and Multidimensional Scale of Social Expression(M-MSSE). Results SER exhibited better improvement of social anxiety symptoms rate than PLA (25.73% vs . 9.46%, P < .05). Neither GCBT differed from GPT (12.33% vs . 22.54%, P = .11) nor SER+GCBT from PLA+GCBT (17.65% vs. 7.69%, P = .20). However, SER+GPT was superior to PLA+GPT (33.33%, vs. 11.43%, P < .05). M-MSSE had superior improvement for SER+GCBT vs PLA+GCBT ( P < .01) but not for SER+GPT vs. PLA+GPT ( P = .80). SASD scores improvement were greater for SER than PLA ( P < .01) and for SER+GCBT vs. PLA+GCBT ( P < .05), but neither GCBT differed from GPT( P = .60) nor SER+GPT differed from PLA+GPT ( P = .09). Conclusions In overall, SER+psychotherapy was superior to psychotherapy alone. SER potentiated GCBT by enhancing social skills acquisition. Trial registration ISRCTN 57551461 .