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Effectiveness of cognitive-behavioural treatment in Social Phobia: a description of the results obtained in a public mental health service

Published online by Cambridge University Press:  11 October 2011

Daniela Leveni
Affiliation:
Centro Psico Sociale, Dipartimento di Salute Mentale dell'Azienda Ospedaliera di Treviglio, Zogno (BG)
Daniele Piacentini
Affiliation:
Centro Psico Sociale, Dipartimento di Salute Mentale dell'Azienda Ospedaliera di Treviglio, Zogno (BG)
Arturo Campana
Affiliation:
Servizio Psichiatrico di Diagnosi e Cura, Ospedale Civile P. Fenaroli, Alzano Lombardo (BG)
Corresponding
E-mail address:

Summary

Objective – Cognitive Behavioural Therapy for the treatment of Social Phobia has proved effective through several controlled trials and meta-analyses. In spite of this the CBT has not spread in clinical field yet. Therefore our aim was to verify the effectiveness of the CBT in a public mental health service and to compare our results with those described by experimental research. Design and setting – Partecipants were 11 public mental health center clients, with a primary diagnosis of Social Phobia (according to DSM-IV criteria). The transportability of CBT to a common clinical setting was examined comparing treatment outcome data, at the end of the treatment and at a six months follow up, with results described in controlled efficacy studies. We employed self completion rating scales relating to both general health conditions and life satisfaction (SF36) and trend of symptoms (LSPS). Moreover we recorded the Clinical Global Impression (CGI) and Patient's Global Impression (PGI). Results – Despite differences in setting, clients and treatment providers, both the magnitude of change from pre treatment and maintenance of change at a six months follow up were comparable with the parallele findings in the efficacy studies. Conclusions –. The results attest the effectiveness of CBT even in a public mental health center setting so, in consideration of the fact that social phobia is a very common disease and involve high degree of severity, chronicity and disability, we hope that this effectual and relatively cheap therapy will be routinely applied in public mental health services.

Riassunto

Scopo – L'efficacia sperimentale della terapia cognitivo–comportamentale nel trattamento della Fobia Sociale, e provata da numerosi studi, tuttavia tali evidenze non risultano avere una ricaduta significativa nella pratica clinica. Abbiamo pertanto voluto verificare l'applicability di tale terapia nel contesto di un normale servizio pubblico di salute mentale e valutarne i risultati per compararli a quelli descritti dagli studi sperimentali. Disegno e setting – Abbiamo introdotto nel nostro centro una terapia cognitivo comportamentale intensiva e trattato i casi di Fobia Sociale che si sono presentati successivamente. In totale sono stati trattati 11 soggetti rispondenti ai criteri diagnostici del DSM–IV e sono stati valutati gli esiti sia al tennine della terapia sia a 6 mesi dal suo tennine. Principali misure di valutazione – Sono stati utilizzati strumenti obiettivi di valutazione: SF/36 per la valutazione della percezione da parte del soggetto del proprio stato di salute generale e mentale, la CGI per la valutazione clinica del terapeuta e PGI per la valutazione di quella del paziente, Liebowitz scale per la valutazione obiettiva dei correlati sintomatologici. Risultati – Nonostante il numero relativamente ridotto di soggetti che componevano il campione e la cronicita del disturbo presentato, sono stati ottenuti miglioramenti statisticamente significativi. Conclusioni – I risultati ottenuti confermano sostanzialmente quelli indicati dagli studi di efficacia e soprattutto l'applicability del metodo proposto anche nel contesto del Servizio Pubblico. Tenuto conto della elevata diffusione epidemiologica del disturbo, dell'elevato carico di malattia che determina nella popolazione generale e del costo relativamente modesto che il trattamento proposto comporta sarebbe auspicabile che esso venisse utilizzato routinariamente nella pratica clinica dei servizi pubblici.

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Copyright
Copyright © Cambridge University Press 2002

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed). American Psychiatric Press: Washington DC.Google Scholar
Andrews, G.(1999). Meeting the unmet need through disease management. In Unmet Need in Psychiatry. Cambridge University Press: Cambridge.Google Scholar
Andrews, G. (2001). La schizofrenia vale i costi? In Schizofrenia (a cura di M. Maj e N. Sartorius). CIC Edizioni Internazionali: Roma.Google Scholar
Andrews, G., Crino, R., Hunt, C, Lampe, L. & Page, A. (1994). The Treatment of Anxiety Disorders. Cambridge University Press: New York.Google Scholar
Andrews, G., Sanderson, K. & Beard, J. (1998). Burden of disease. Methods of calculating disability from mental disorders. British Journal of Psychiatry 173, 123131.CrossRefGoogle Scholar
Andrews, G., Hall, W., Teeson, M. & Henderson, S. (1999). The Mental Health of Australians. National Survey of Mental Health and Wellbeing Report 2 <http://www.health.gov.au/hsdd/mentalhe/resources/reports/pdf/mentalhealth.pdf>..>Google Scholar
Andrews, G., Issakidis, C. & Slade, T. (2000). Vie Clinical Significance of Mental Disorders. National Workshop on Comorbidity, Camberra, ACT.Google Scholar
Cottraux, J., Note, I., Albuisson, E., Yao, S.N., Note, B., Mollard, E., Bonasse, F., Jalenques, I., Guerin, J. & Coudert, A.J. (2000). Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial. Psyclioterapy and Psychosomatics 69, 137146.CrossRefGoogle ScholarPubMed
Faravelli, C, Zucchi, T. & Viviani, B. (2000). Epidemiology of social phobia: a clinical approach. European Psychiatry 15, 1724.CrossRefGoogle ScholarPubMed
Ginsberg, G. & Marks, I. (1977). Costs and benefits of behaviour therapy. Psycological Medicine 7, 685700.CrossRefGoogle Scholar
Guy, W. (1976). ECDEU Assessment Manual for Psychophannacology. DHEW Publication N° (ADM) 76338.Google Scholar
Heinberg, R.G., Dodge, C.S. & Hope, D.A. (1990). Cognitive behavioural treatment for social phobia: comparison with a placebo control. Cognitive Therapy and Research 14, 123.CrossRefGoogle Scholar
Leveni, D. & Piacentini, D. (2000). La terapia cognitivo comportamentale dei disturbi d'ansia. In La Mente Prigioniera (a cura di:Lorenzinie, R.Sassaroli, S.), pp. 283309. Cortina Editore: Milano.Google Scholar
Leveni, D., Mazzoleni, D. & Piacentini, D. (1999). Trattamento cognitivo comportamentale di gruppo del Disturbo da Attacchi di Panico: descrizione dei risultati ottenuti in un servizio di salute mentale. Epidemiologia e Psichiatria Sociale 8, 270275.CrossRefGoogle Scholar
Liebowitz, M.R. (1987). Social phobia. Modern Problems on Pliarmacopsychiatry 22, 141.Google ScholarPubMed
Montgomery, S.A. (1999). Social phobia: diagnosis, severity and implications for treatment. European Archives of Psychiatry and Clinical Neuroscience 249, Suppl. 1, SI6.CrossRefGoogle ScholarPubMed
Munzel, U. & Bandelow, B. (1998). The use of parametric vs. non parametric tests in the evaluation of rating scales. Pliannacopsychiatry 31, 222224.Google Scholar
Murray, C.J.L. & Lopez, A.D. (1996). The Global Burden of Disease. Harvard University Press: Cambridge.Google ScholarPubMed
Nutt, D., Baldwin, D., Beaumont, G., Bell, C, Denny, C, Knapp, M., Maxwell, R., McNicholas, F. & Wells, A. (1999). Guidelines for the management of Social Phobia. Primary Care Psychiatry 5, 147155.Google Scholar
Piacentini, D., Leveni, D., Biffi, G., Calzeroni, A., Sileoni, A., Scarone, S. & Campana, A. (2001). Efficacia nella pratica della terapia cognitivo-comportamentale di gruppo nel trattamento del Disturbo da Attacchi di Panico: analisi dei risultati in due centri di salute mentale. In Progetto Nazionale Salute Mentale (a cura di Morosini, P., GiroIamo, G.de. Picardie, AFabio, F. di), pp. 143146. Istituto Superiore di Sanita, Rapporti ISTISAN n° 01/27.Google Scholar
Sareen, L. &, Stein, M. (2000). A review of the epidemiology and approches to the treatment of social anxiety disorder. Drugs 59, 497509.CrossRefGoogle Scholar
Shear, M.K. & Beidel, D.C. (1998). Psychoterapy in the overall management strategy for social anxiety disorder. Journal of Clinical Psychiatry 59, Suppl 17, 3946.Google Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, k., Janavs, J., Bonora, L.I., Keskiner, A., Shinka, J., Knapp, E., Sheehan, M.F. & Dunbarg, C. (1997). Reliability and validity of the Mini International Neuropsychiatric Interview (M.I.N.I.). European Psychiatry 12, 232241.CrossRefGoogle Scholar
Stravynski, A. & Greenberg, D. (1998). The treatment of social phobia: a critical assessment. Ada Psychiatrica Scandinavica 98, 171181.CrossRefGoogle ScholarPubMed
Ware, J.E.. & Sherbourne, C.D. (1992). The MOS 36-item Short Form Health Survey. Conceptual Framework and item selection. Medical Care 30, 473.CrossRefGoogle ScholarPubMed
World Health Organization (2000). Management of Mental Disorders. Cambridge University Press: Cambridge.Google Scholar

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