Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia

Background No controlled trial of treatment of generalised social phobia ha s been conducted in general practice. Aims To examine the efficacy of sertraline or exposure therapy. administere d alone or in combination in this setting. Method Study was of a randomised, double-blind design. Patients (n=387) rec eived sertraline 50-150 mg or placebo for 24 weeks. Patients were additiona lly randomised to exposure therapy or general medical care. Results Sertraline-treated patients were significantly more improved than n on-sertraline-treated patients (chi (2)=12.53, P <0.001; odds ratio=0.534; 95% CI 0.347-0.835). No significant difference was observed between exposur e- and non-exposure-treated patients (chi (2)=2.18, P=0.140; odds ratio=0.7 32; 95% CI 0.475-1.134). In the pairwise comparisons, combined sertraline a nd exposure (chi (2)=12.32; P <0.001) and sertraline (chi (2)=10.13; P=0.00 2) were significantly superior to placebo. Conclusions Sertraline is an effective treatment for generalised social pho bia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary car e.