title: A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder.
abstract: BACKGROUND
  Internet-based cognitive behavior therapy (CBT) has been shown to be a promising method to disseminate cognitive behavior therapy for social anxiety disorder (SAD). Several trials have demonstrated that Internet-based CBT can be effective for SAD in the shorter term. However, the long-term effects of Internet-based CBT for SAD are less well known.
  
  
  OBJECTIVE
  Our objective was to investigate the effect of Internet-based CBT for SAD 5 years after completed treatment.
  
  
  METHODS
  We conducted a 5-year follow-up study of 80 persons with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires. The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires.
  
  
  RESULTS
  Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F(3,98-102) = 16.05 - 29.20, P < .001) indicating improvement. From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI] 66.1-76.5) to 40.3 (95% CI 35.2 - 45.3). The effect sizes of the LSAS-SR were large (Cohen's d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment.
  
  
  CONCLUSIONS
  Internet-based CBT for SAD is a treatment that can result in large and enduring effects.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01145690; http://clinicaltrials.gov/ct2/show/NCT01145690 (Archived by WebCite at http://www.webcitation.org/5ygRxDLfK).
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. erik.hedman.2@ki.se
authors.forename: Erik
authors.initials: E
authors.lastname: Hedman
authors.forename: Tomas
authors.initials: T
authors.lastname: Furmark
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
authors.forename: Christian
authors.initials: C
authors.lastname: Rück
authors.forename: Nils
authors.initials: N
authors.lastname: Lindefors
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors