Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-25T04:42:21.189Z Has data issue: false hasContentIssue false
  • English
  • Français

Symptomatic Treatment of Agoraphobia and Social Phobias: A Follow-up Study

Published online by Cambridge University Press:  29 January 2018

Peter Tyrer  and
Derek Steinberg
Peter Tyrer
Affiliation:
University of Southampton, South Academic Block, Southampton General Hospital, Tremona Road, Southampton, SO9 4XY
Derek Steinberg
Affiliation:
Regional Adolescent Unit, Long Grove Hospital, Epsom, Surrey; Kingston Hospital; and St. Luke's Hospital, Guildford, Surrey
Get access Rights & Permissions [Opens in a new window]

Summary

  1. 1. Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors.

  2. 2. Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received.

  3. 3. There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed.

  4. 4. Degree of personality disorder showed a significant negative correlation (p = –0.6) with improvement in the phenelzine group but not in those receiving placebo originally.

  5. 5. Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed.

  6. 6. The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 127 , Issue 2 , August 1975 , pp. 163 - 168
Copyright
Copyright © Royal College of Psychiatrists, 1975 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boulougouris, J. C. & Marks, I. M. (1969) Implosion (flooding)—a new treatment for phobias. British Medical Journal, ii, 721–3.Google Scholar
Coppen, A., Noguera, R., Bailey, J., Burns, B. H., Swani, M. S., Hare, E. H., Gardner, R. & Maggs, R. (1971) Prophylactic lithium in affective disorders. Lancet, ii, 275–9.Google Scholar
Crisp, A. H. (1966) ‘Transference', ‘symptom emergence’ and ‘social repercussion’ in behaviour therapy. British Journal of Medical Psychology, 39, 179–96.Google Scholar
Crowe, M. J., Marks, I. M., Agras, W. S. & Leitenberg, H. (1972) Time-limited desensitization, implosion and shaping for phobic patients: a crossover study. Behaviour Research & Therapy, 10, 219–28.Google Scholar
Franke, K. H. (1968) On the treatment of phobias with a new anxiolytic drug. Arzneimittel-Forsch, 18, 1570–1.Google Scholar
Freeman, T. (1968) Psychoanalytic critique of behaviour therapy. British Journal of Medical Psychology, 41, 53–9.Google Scholar
Gelder, M. G. & Marks, I. M. (1966) Severe agoraphobia: a controlled prospective therapeutic trial. British Journal of Psychiatry, 112, 309–19.CrossRefGoogle Scholar
Gelder, M. G., Marks, I. M. & Wolff, H. H. (1967) Desensitization and psychotherapy in the treatment of phobic states: a controlled inquiry. British Journal of Psychiatry, 113, 53–73.Google Scholar
Klein, D. F. (1964) Delineation of two drug-responsive anxiety syndromes. Psychopharmacologia (Berl.), 5, 397–408.Google Scholar
Lewis, A. (1974) Psychopathic personality: a most elusive category. Psychological Medicine, 4, 133–40.Google Scholar
Lipsedge, M. S., Hajioff, J., Huggins, P., Napier, L., Pearce, J., Pike, D. J. & Rich, M. (1973) The management of severe agoraphobia: a comparison of iproniazid and systematic desensitization. Psychopharmacologia (Berl.), 32, 67–80.Google Scholar
Malan, D. H., Bacal, H. A., Heath, E. S. & Balfour, F. H. G. (1968) A study of psychodynamic changes in untreated neurotic patients. British Journal of Psychiatry, 114, 525–51.CrossRefGoogle ScholarPubMed
Marks, I. M. (1971) Phobic disorders four years after treatment: a prospective follow-up. British Journal of Psychiatry, 118, 683–9.Google Scholar
Pitt, B. M. N. (1974) Withdrawal symptoms after stopping phenelzine? British Medical Journal, ii, 332–3.Google Scholar
Sargant, W. (1966) Psychiatric treatment in general teaching hospitals: a plea for a mechanistic approach. British Medical Journal, ii, 257–62.Google Scholar
Snaith, R. P. (1974) A method of psychotherapy based on relaxation techniques. British Journal of Psychiatry, 124, 473–81.Google Scholar
Solyom, L., Heseltine, G. F., McClure, D. J., Solyom, C., Ledwidoe, B. & Steinberg, G. (1973) Behaviour therapy versus drug therapy in the treatment of phobic neurosis. Canadian Psychiatric Association Journal, 18, 25–32.Google Scholar
Steinberg, D. (1972) M.Phil. Thesis, University of London (unpublished).Google Scholar
Tyrer, P., Candy, J. & Kelly, D. (1973a) Phenelzine in phobic anxiety: a controlled trial. Psychological Medicine, 3, 120–4.Google Scholar
Tyrer, P., Candy, J. & Kelly, D. (1973b) A study of the clinical effects of phenelzine and placebo in the treatment of phobic anxiety. Psychopharmacologia (Berl.), 32, 237–54.Google Scholar
Walton, H.J. & Presley, A. S. (1973) Use of a category system in the diagnosis of abnormal personality. British Journal of Psychiatry, 122, 259–68.Google Scholar
Watson, J. P., Gaind, R. & Marks, I. M. (1971) Prolonged exposure: a rapid treatment for phobias. British Medical Journal, i, 13–15.Google Scholar
Wolpe, J. (1961) The systematic desensitization treatment of neuroses. Journal of Nervous and Mental Disease, 132, 189–203.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.