Exposure therapy and sertraline in social phobia: 1-year follow-up of a randomised controlled trial

BACKGROUND: Maintenance of treatment effect is important for the choice of treatment for social phobia. AIMS: To examine the effect of exposure therapy and sertraline 28 weeks after cessation of medical treatment. METHOD: In this study 375 patients with social phobia were randomised to treatment with sertraline or placebo for 24 weeks, with or without the addition of exposure therapy. Fifty-two weeks after inclusion, 328 patients were evaluated by the same psychometric tests as at baseline and the end of treatment (24 weeks). RESULTS: The exposure therapy group and the placebo group had a further improvement in scores on social phobia during follow-up: mean change in the Clinical Global Impression - Social Phobia overall severity score was 0.45 (95% CI 0.16-0.65, P < 0.01) for the exposure group, and 0.25 (95% CI 0.00-0.48, P < 0.05) for the placebo group. At week 52 the sertraline plus exposure group and the sertraline-alone group had a significant deterioration on the 36-item Short Form Health Survey compared with exposure alone. CONCLUSIONS: Exposure therapy alone yielded a further improvement during follow-up, whereas exposure therapy combined with sertraline and sertraline alone showed a tendency towards deterioration after the completion of treatment.