title: A meta-analysis of pharmacotherapy for social anxiety disorder: an examination of efficacy, moderators, and mediators.
abstract: Social anxiety disorder (SAD) is among the most prevalent mental disorders, associated with impaired functioning and poor quality of life. Pharmacotherapy is the most widely utilized treatment option. The current study provides an updated meta-analytic review of the efficacy of pharmacotherapy and examines moderators and mediators of treatment efficacy. Areas Covered: A comprehensive search of the current literature yielded 52 randomized, pill placebo-controlled trials of pharmacotherapy for adults diagnosed with SAD. Data on potential mediators of treatment outcome were collected, as well as data necessary to calculate pooled correlation matrices to compute indirect effects. Expert Opinion: The overall effect size of pharmacotherapy for SAD is small to medium (Hedges' g = 0.41). Effect sizes were not moderated by age, sex, length of treatment, initial severity, risk of study bias, or publication year. Furthermore, reductions in symptoms mediated pharmacotherapy's effect on quality of life. Support was found for reverse mediation. Future directions may include sustained efforts to examine treatment mechanisms of pharmacotherapy using rigorous longitudinal methodology to better establish temporal precedence.
authors.affiliation: a Department of Psychological and Brain Sciences , Boston University , Boston , USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Curtiss
authors.affiliation: a Department of Psychological and Brain Sciences , Boston University , Boston , USA.
authors.forename: Leigh
authors.initials: L
authors.lastname: Andrews
authors.affiliation: b The University of Texas at Austin , Department of Psychology and Institute for Mental Health Research , Austin , USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Davis
authors.affiliation: b The University of Texas at Austin , Department of Psychology and Institute for Mental Health Research , Austin , USA.
authors.forename: Jasper
authors.initials: J
authors.lastname: Smits
authors.affiliation: a Department of Psychological and Brain Sciences , Boston University , Boston , USA.
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Hofmann
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D003071:Cognition / Q000187:drug effects; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000072861:Phobia, Social / Q000188:drug therapy*; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Pharmacotherapy; meta-analysis; quality of life; social anxiety disorder