scholarly journals Therapeutic Effectiveness of Galphimia glauca in Young People with Social Anxiety Disorder: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ofelia Romero-Cerecero ◽  
Ana Laura Islas-Garduño ◽  
Alejandro Zamilpa ◽  
Ma. Dolores Pérez-García ◽  
Jaime Tortoriello
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Control Group ◽  
Efficacy And Safety ◽  
Double Blind ◽  
A Value ◽  
Double Blind Clinical Trial ◽  
End Of Treatment ◽  
Significant Difference

Social anxiety is one of the most common disorders found in the population attending the first level of health care. Galphimia glauca has been used for many years in Mexican traditional medicine to treat “nervous disorders”. A standardized extract of this species has been evaluated in clinical studies that have proven its efficacy and safety in patients with generalized anxiety disorder. In this work, a double-blind clinical trial was carried out, using sertraline as a control. Patients from both sexes (18 to 35 years old) with moderate or severe social anxiety were included. Experimental group was treated daily (orally), for 10 weeks, with an extract from G. glauca containing 0.374 mg/dose of Galphimine-B (G-B, active compound). Patients in the control group were given sertraline (50 mg) in the same conditions. All patients were evaluated every two weeks. Another assessment was done one month after the end of the administration period. A total of 34 patients was included, 17 in each group. Women were predominant, and the mean age was 25 ± 4.7 years. In patients who received the G. glauca standardized extract, a significant reduction in anxiety was observed, with a value (in the Brief Social Phobia Scale) of 41.1±10.3 points at the start and 11.2±5.6 points at the end of treatment, while patients treated with sertraline had a value of 37.7±7.3 points at the beginning and 11.1±5.2 points at the end. No significant difference was observed between the treated groups. In a similar way, the health scale showed a gradual and continuous improvement in each of the five evaluations. In conclusion, the 10-week oral administration of G. glauca standardized extract showed efficacy and safety in patients with social anxiety disorder, without showing a significant difference from patients treated with sertraline.

scholarly journals Effectiveness of a Participatory and Interactive Virtual Reality Intervention in Patients With Social Anxiety Disorder: Longitudinal Questionnaire Study (Preprint)

2020 ◽  
Author(s):  
Hyun-Jin Kim ◽  
Seulki Lee ◽  
Dooyoung Jung ◽  
Ji-Won Hur ◽  
Heon-Jeong Lee ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Anxiety Scale ◽  
Negative Evaluation ◽  
Fear Of Negative Evaluation ◽  
Control Group ◽  
Significant Difference ◽  
Healthy Control

BACKGROUND Social anxiety disorder (SAD) is characterized by excessive fear of negative evaluation and humiliation in social interactions and situations. Virtual reality (VR) treatment is a promising intervention option for SAD. OBJECTIVE The purpose of this study was to create a participatory and interactive VR intervention for SAD. Treatment progress, including the severity of symptoms and the cognitive and emotional aspects of SAD, was analyzed to evaluate the effectiveness of the intervention. METHODS In total, 32 individuals with SAD and 34 healthy control participants were enrolled in the study through advertisements for online bulletin boards at universities. A VR intervention was designed consisting of three stages (introduction, core, and finishing) and three difficulty levels (easy, medium, and hard) that could be selected by the participants. The core stage was the exposure intervention in which participants engaged in social situations. The effectiveness of treatment was assessed through Beck Anxiety inventory (BAI), State‐Trait Anxiety Inventory (STAI), Internalized Shame Scale (ISS), Post-Event Rumination Scale (PERS), Social Phobia Scale (SPS), Social Interaction Anxiety Scale (SIAS), Brief-Fear of Negative Evaluation Scale (BFNE), and Liebowitz Social Anxiety Scale (LSAS). RESULTS In the SAD group, scores on the BAI (<i>F</i>=4.616, <i>P</i>=.009), STAI-Trait (<i>F</i>=4.670, <i>P</i>=.004), ISS (<i>F</i>=6.924, <i>P</i>=.001), PERS-negative (<i>F</i>=1.008, <i>P</i>&lt;.001), SPS (<i>F</i>=8.456, <i>P</i>&lt;.001), BFNE (<i>F</i>=6.117, <i>P</i>=.004), KSAD (<i>F</i>=13.259, <i>P</i>&lt;.001), and LSAS (<i>F</i>=4.103, <i>P</i>=.009) significantly improved over the treatment process. Compared with the healthy control group before treatment, the SAD group showed significantly higher scores on all scales (<i>P</i>&lt;.001), and these significant differences persisted even after treatment (<i>P</i>&lt;.001). In the comparison between the VR treatment responder and nonresponder subgroups, there was no significant difference across the course of the VR session. CONCLUSIONS These findings indicated that a participatory and interactive VR intervention had a significant effect on alleviation of the clinical symptoms of SAD, confirming the usefulness of VR for the treatment of SAD. VR treatment is expected to be one of various beneficial therapeutic approaches in the future. CLINICALTRIAL Clinical Research Information Service (CRIS) KCT0003854; https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=13508

scholarly journals Effectiveness of a Participatory and Interactive Virtual Reality Intervention in Patients With Social Anxiety Disorder: Longitudinal Questionnaire Study

10.2196/23024 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e23024
Author(s):  
Hyun-Jin Kim ◽  
Seulki Lee ◽  
Dooyoung Jung ◽  
Ji-Won Hur ◽  
Heon-Jeong Lee ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Anxiety Scale ◽  
Negative Evaluation ◽  
Fear Of Negative Evaluation ◽  
Control Group ◽  
Significant Difference ◽  
Healthy Control

Background Social anxiety disorder (SAD) is characterized by excessive fear of negative evaluation and humiliation in social interactions and situations. Virtual reality (VR) treatment is a promising intervention option for SAD. Objective The purpose of this study was to create a participatory and interactive VR intervention for SAD. Treatment progress, including the severity of symptoms and the cognitive and emotional aspects of SAD, was analyzed to evaluate the effectiveness of the intervention. Methods In total, 32 individuals with SAD and 34 healthy control participants were enrolled in the study through advertisements for online bulletin boards at universities. A VR intervention was designed consisting of three stages (introduction, core, and finishing) and three difficulty levels (easy, medium, and hard) that could be selected by the participants. The core stage was the exposure intervention in which participants engaged in social situations. The effectiveness of treatment was assessed through Beck Anxiety inventory (BAI), State‐Trait Anxiety Inventory (STAI), Internalized Shame Scale (ISS), Post-Event Rumination Scale (PERS), Social Phobia Scale (SPS), Social Interaction Anxiety Scale (SIAS), Brief-Fear of Negative Evaluation Scale (BFNE), and Liebowitz Social Anxiety Scale (LSAS). Results In the SAD group, scores on the BAI (F=4.616, P=.009), STAI-Trait (F=4.670, P=.004), ISS (F=6.924, P=.001), PERS-negative (F=1.008, P<.001), SPS (F=8.456, P<.001), BFNE (F=6.117, P=.004), KSAD (F=13.259, P<.001), and LSAS (F=4.103, P=.009) significantly improved over the treatment process. Compared with the healthy control group before treatment, the SAD group showed significantly higher scores on all scales (P<.001), and these significant differences persisted even after treatment (P<.001). In the comparison between the VR treatment responder and nonresponder subgroups, there was no significant difference across the course of the VR session. Conclusions These findings indicated that a participatory and interactive VR intervention had a significant effect on alleviation of the clinical symptoms of SAD, confirming the usefulness of VR for the treatment of SAD. VR treatment is expected to be one of various beneficial therapeutic approaches in the future. Trial Registration Clinical Research Information Service (CRIS) KCT0003854; https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=13508

Duloxetine for the Treatment of Generalized Social Anxiety Disorder: A Preliminary Randomized Trial of Increased Dose to Optimize Response

CNS Spectrums ◽  
2010 ◽  
Vol 15 (7) ◽  
pp. 436-443 ◽  
Author(s):  
Naomi M. Simon ◽  
John J. Worthington ◽  
Samantha J. Moshier ◽  
Elizabeth H. Marks ◽  
Elizabeth A. Hoge ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Controlled Study ◽  
Open Label ◽  
Double Blind ◽  
Significant Difference ◽  
Moderate Effect Size ◽  
Limited Power ◽  
Preliminary Support

ABSTRACTObjective: This is the first trial examining duloxetine for generalized social anxiety disorder (GSAD) and the effect of increased dose for those without early remission.Methods: Individuals (n=39) with GSAD received 6 weeks of open-label duloxetine 60 mg/day; those with a Liebowitz Social Anxiety Disorder Scale (LSAS) score >30 at week 6 were randomized in double-blind fashion to an additional 18 weeks of continued duloxetine 60 mg/day or to duloxetine 120 mg/day.Results: Duloxetine was associated with a significant LSAS reduction at week 6 (91.3 [17.7] to 69.8 [28.5], paired t [df]=5.2 [38], P<.0001), and randomized participants overall continued to improve at week 24 (74.6 [23.9] to 60.3 [29.7]; paired t [df]=3.3 [27], P=.0026). Though the increased dose strategy was associated with a moderate effect size (Cohen's d=.57), there was no significant difference at week 24 endpoint in LSAS reduction (20.5 [26.0] versus 7.3 [17.2], t [df]=1.6 [26], P=.13) nor remission (33% versus 8%) for duloxetine with dose increased to 120 mg/day compared to duloxetine continued at 60 mg/day. Overall, 44% (17/39) discontinued prior to week 24.Conclusions: Though with limited power, these data provide preliminary support for the efficacy of duloxetine for GSAD, and suggest continued improvement but limited remission overall at 24 weeks for individuals remaining symptomatic at week 6. These observations warrant further controlled study.

scholarly journals Cognitive Therapy for Social Anxiety Disorder in Adolescents: A Development Case Series

2015 ◽  
Vol 44 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Eleanor Leigh ◽  
David M. Clark
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Young People ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Case Series ◽  
Process Measures ◽  
General Anxiety ◽  
Differential Effectiveness ◽  
End Of Treatment

Background: Social anxiety disorder is common and typically starts in childhood or adolescence. Cognitive Therapy for Social Anxiety Disorder (CT-SAD) in adults is a well-established treatment that shows strong evidence of differential effectiveness when compared to other active treatments. In contrast, CBT approaches to social anxiety in young people have yet to demonstrate differential effectiveness and there is some evidence that young people with social anxiety disorder respond less well than those with other anxiety disorders. Aims: To adapt CT-SAD for use with adolescents and conduct a pilot case series. Method: Five adolescents, aged 11–17 years, with a primary DSM-5 diagnosis of social anxiety disorder received a course of CT-SAD adapted for adolescents. Standardized clinical interview and questionnaire assessments were conducted at pre and posttreatment, and 2 to 3-month follow-up. Results: All five participants reported severe social anxiety at baseline and achieved remission by the end of treatment. Significant improvements were also observed in general anxiety, depression, concentration in the classroom, and putative process measures (social anxiety related thoughts, beliefs and safety behaviours). Conclusions: An adapted form of CT-SAD shows promise as a treatment for adolescents.

scholarly journals Effectiveness of Preoperative Chlorhexidine Mouthwash on Pain After Lower Posterior Teeth Removal: A Randomized, Double-Blind Clinical Trial

2020 ◽  
Vol 12 (4) ◽  
pp. 112-119
Author(s):  
Abbas Haghighat ◽  
Shaqayeq Ramezanzade
Keyword(s):  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Mouth Rinse ◽  
Pain Level ◽  
Double Blind ◽  
Posterior Teeth ◽  
Post Operative Pain ◽  
Double Blind Clinical Trial ◽  
Significant Difference

Background: Pain is one of the most common complications after tooth extraction and pain control is a crucial part of the procedure. The purpose of this study was to investigate the influence of 0.2% (w/v) chlorhexidine (CHX) gluconate mouth rinse on the severity of post-extraction pain. Methods: A prospective, randomized, double-blind trial was conducted among 170 subjects. Subjects were instructed to rinse with 15 mL of CHX mouth rinse (study group) or placebo (control group) 0.5 to 1 hour before extraction. Post-operative pain was evaluated considering the number of taken rescue analgesics and using a visual analog scale (VAS) that each case completed 6, 12, 24, and 48 hours after the surgery. The Mann-Whitney U test was performed in this regard. Results: There were no significant differences between the two groups regarding demographic variables (P>0.05). The preoperative use of CHX mouth rinse showed a better performance in mitigating the perceived pain. A significant difference in the pain level (P=0.001) was found only at the 6th hour postoperatively although there was no significant difference in the pain level between the two groups (P>0.05) at all other times (12th, 24th, 48th hours). The total number of analgesics that were taken by the study group was significantly lower compared to the control group (P=0.042). Conclusions: The preoperative CHX mouth rinse could be a beneficial choice for reducing pain after simple tooth extractions.

Orbitofrontal hyperactivity in social anxiety disorder patients: An fmri study

2011 ◽  
Vol 26 (S2) ◽  
pp. 179-179 ◽  
Author(s):  
R. Sladky ◽  
C. Kraus ◽  
J. Tröstl ◽  
S. Kasper ◽  
R. Lanzenberger ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Orbitofrontal Cortex ◽  
Posterior Cingulate Cortex ◽  
Functional Coupling ◽  
Healthy Controls ◽  
Brain Volumes ◽  
Significant Difference ◽  
Image Position

IntroductionSocial anxiety disorder (SAD) refers to persistent fear of social situations in which the person is exposed to possible scrutiny by others. Anxiety disorders are associated with dysbalanced inhibition within the limbic system towards threatening stimuli (Phillips 2003). It has been shown SAD patients are particularly sensitive towards faces displaying harsh emotions (Phan 2006).ObjectivesIn this study we used fMRI to investigate activation differences between 14 SAD patients and 15 matched healthy controls. The subjects performed a facial emotion discrimination paradigm including a control condition using shape discrimination (modified version of Hariri 2002).AimsThe aim of this study was to investigate emotion task-specific differences in brain activation of patients and healthy controls.MethodsAfter clinical assessment, 225 whole-brain volumes (TR = 1.8s) were acquired on a Siemens TRIO 3T MR scanner and analyzed using SPM8.ResultsThe paradigm activated the amygdalae, the fusiform gyri, the posterior cingulate cortex and the orbitofrontal cortex (OFC) (A). There was a hyperactivation of the OFC in patients compared to healthy controls (B). We found no significant difference in the amygdalae or fusiforme gyrus.ConclusionAlthough not in a social threat situation, SAD patients showed more activity in the orbitofrontal cortex. In contrast to other studies we found no differences in other brain areas indicating an optimized control condition. According to the functional coupling between prefrontal areas and the amygdalae, these data are consistent with an increased effort in down-regulating amygdalar activation by the orbitofrontal cortex.

scholarly journals A Multicenter, Randomized, Double-blind, Placebo-Controlled Trial ofParoxetine in Children and Adolescents With Social Anxiety Disorder

2004 ◽  
Vol 61 (11) ◽  
pp. 1153 ◽  
Author(s):  
Karen Dineen Wagner ◽  
Ray Berard ◽  
Murray B. Stein ◽  
Erica Wetherhold ◽  
David J. Carpenter ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Children And Adolescents ◽  
Social Anxiety Disorder ◽  
Controlled Trial ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals Escitalopram in the treatment of social anxiety disorder

2005 ◽  
Vol 186 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Siegfried Kasper ◽  
Dan J. Stein ◽  
Henrik Loft ◽  
Rico Nil
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Primary Outcome Measure ◽  
Double Blind ◽  
Good Tolerability ◽  
Liebowitz Social Anxiety Scale ◽  
Social Components ◽  
To Receive

BackgroundSelective serotonin reuptake inhibitors are effective in the treatment of social anxiety disorder and are currently regarded as the pharmacotherapy of choice.AimsTo investigate the efficacy and tolerability of escitalopram in the treatment of generalised social anxiety disorder.MethodPatients with generalised social anxiety disorder were randomised to receive placebo (n=177) or 10–20 mg escitalopram (n=181) in a 12-week, double-blind trial. The primary outcome measure was the mean change from baseline to last assessment in the Liebowitz Social Anxiety Scale (LSAS) total score.ResultsThe study showed a statistically superior therapeutic effect for escitalopram compared with placebo on the LSAS total score (P=0.005). There were significantly more responders to treatment for escitalopram than for placebo (54% v. 39%; P < 0.0 1). The clinical relevance of these findings was supported by significant reduction in the work and social components of the Sheehan Disability Scale and by the good tolerability of escitalopram treatment.ConclusionsEscitalopram was efficacious and well tolerated in the treatment of generalised social anxiety disorder.

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