Predictors of Response in Generalized Social Phobia: Effect of Age of Onset

Michael Van Ameringen, Jonathan Oakman, Catherine Mancini, Beth Pipe, Henry Chung

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are the gold standard for the pharmacological treatment of generalized social phobia (GSP). However, little is known about the predictors of response to treatment. Two hundred and four outpatients with GSP were randomized to sertraline (Zoloft) or placebo, for a 20-week double-blind study, with a flexible dose range of sertraline 50 to 200 mg/d. Response was defined as the percentage of patients with a Clinical Global Impression-Improvement scale (CGI-I) of 1 (very much improved) or 2 (much improved). Outcome analyses were conducted using regression models including treatment group as a categorical predictor and study visit as a repeated measure. Dependent measures included Marks Fear Questionnaire (MFQ), Brief Social Phobia Scale (BSPS), CGI-I, and Sheehan Disability Scale (SDS). We investigated several possible predictors of response to treatment including DSM-IV comorbidity, age, sex, age of onset of GSP, and duration of illness. Patients with later-onset (especially adult-onset) GSP tend to have a better response to treatment than those with earlier-onset GSP. This result generally appears in our analyses as a 2-way interaction, where the association with response is greatest for patients with adult-onset GSP (in contrast to those with child or adolescent onset). This finding is most robust for symptom measures, but is still apparent for the Sheehan measure of disability at work. This advantage for later-onset GSP can be accounted for neither by severity of illness nor by duration of illness. Superior treatment outcome for later-onset GSP may be mediated by the degree of social and family disability.

Original languageEnglish (US)
Pages (from-to)42-48
Number of pages7
JournalJournal of Clinical Psychopharmacology
Volume24
Issue number1
DOIs
StatePublished - Feb 2004
Externally publishedYes

Fingerprint

Age of Onset
Sertraline
Therapeutics
Social Phobia
Serotonin Uptake Inhibitors
Double-Blind Method
Diagnostic and Statistical Manual of Mental Disorders
Fear
Comorbidity
Outpatients
Placebos
Pharmacology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Predictors of Response in Generalized Social Phobia : Effect of Age of Onset. / Van Ameringen, Michael; Oakman, Jonathan; Mancini, Catherine; Pipe, Beth; Chung, Henry.

In: Journal of Clinical Psychopharmacology, Vol. 24, No. 1, 02.2004, p. 42-48.

Research output: Contribution to journalArticle

Van Ameringen, Michael ; Oakman, Jonathan ; Mancini, Catherine ; Pipe, Beth ; Chung, Henry. / Predictors of Response in Generalized Social Phobia : Effect of Age of Onset. In: Journal of Clinical Psychopharmacology. 2004 ; Vol. 24, No. 1. pp. 42-48.
@article{19f531165684447d9f5d83899492753d,
title = "Predictors of Response in Generalized Social Phobia: Effect of Age of Onset",
abstract = "Selective serotonin reuptake inhibitors (SSRIs) are the gold standard for the pharmacological treatment of generalized social phobia (GSP). However, little is known about the predictors of response to treatment. Two hundred and four outpatients with GSP were randomized to sertraline (Zoloft) or placebo, for a 20-week double-blind study, with a flexible dose range of sertraline 50 to 200 mg/d. Response was defined as the percentage of patients with a Clinical Global Impression-Improvement scale (CGI-I) of 1 (very much improved) or 2 (much improved). Outcome analyses were conducted using regression models including treatment group as a categorical predictor and study visit as a repeated measure. Dependent measures included Marks Fear Questionnaire (MFQ), Brief Social Phobia Scale (BSPS), CGI-I, and Sheehan Disability Scale (SDS). We investigated several possible predictors of response to treatment including DSM-IV comorbidity, age, sex, age of onset of GSP, and duration of illness. Patients with later-onset (especially adult-onset) GSP tend to have a better response to treatment than those with earlier-onset GSP. This result generally appears in our analyses as a 2-way interaction, where the association with response is greatest for patients with adult-onset GSP (in contrast to those with child or adolescent onset). This finding is most robust for symptom measures, but is still apparent for the Sheehan measure of disability at work. This advantage for later-onset GSP can be accounted for neither by severity of illness nor by duration of illness. Superior treatment outcome for later-onset GSP may be mediated by the degree of social and family disability.",
author = "{Van Ameringen}, Michael and Jonathan Oakman and Catherine Mancini and Beth Pipe and Henry Chung",
year = "2004",
month = "2",
doi = "10.1097/01.jcp.0000104909.75206.6f",
language = "English (US)",
volume = "24",
pages = "42--48",
journal = "Journal of Clinical Psychopharmacology",
issn = "0271-0749",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Predictors of Response in Generalized Social Phobia

T2 - Effect of Age of Onset

AU - Van Ameringen, Michael

AU - Oakman, Jonathan

AU - Mancini, Catherine

AU - Pipe, Beth

AU - Chung, Henry

PY - 2004/2

Y1 - 2004/2

N2 - Selective serotonin reuptake inhibitors (SSRIs) are the gold standard for the pharmacological treatment of generalized social phobia (GSP). However, little is known about the predictors of response to treatment. Two hundred and four outpatients with GSP were randomized to sertraline (Zoloft) or placebo, for a 20-week double-blind study, with a flexible dose range of sertraline 50 to 200 mg/d. Response was defined as the percentage of patients with a Clinical Global Impression-Improvement scale (CGI-I) of 1 (very much improved) or 2 (much improved). Outcome analyses were conducted using regression models including treatment group as a categorical predictor and study visit as a repeated measure. Dependent measures included Marks Fear Questionnaire (MFQ), Brief Social Phobia Scale (BSPS), CGI-I, and Sheehan Disability Scale (SDS). We investigated several possible predictors of response to treatment including DSM-IV comorbidity, age, sex, age of onset of GSP, and duration of illness. Patients with later-onset (especially adult-onset) GSP tend to have a better response to treatment than those with earlier-onset GSP. This result generally appears in our analyses as a 2-way interaction, where the association with response is greatest for patients with adult-onset GSP (in contrast to those with child or adolescent onset). This finding is most robust for symptom measures, but is still apparent for the Sheehan measure of disability at work. This advantage for later-onset GSP can be accounted for neither by severity of illness nor by duration of illness. Superior treatment outcome for later-onset GSP may be mediated by the degree of social and family disability.

AB - Selective serotonin reuptake inhibitors (SSRIs) are the gold standard for the pharmacological treatment of generalized social phobia (GSP). However, little is known about the predictors of response to treatment. Two hundred and four outpatients with GSP were randomized to sertraline (Zoloft) or placebo, for a 20-week double-blind study, with a flexible dose range of sertraline 50 to 200 mg/d. Response was defined as the percentage of patients with a Clinical Global Impression-Improvement scale (CGI-I) of 1 (very much improved) or 2 (much improved). Outcome analyses were conducted using regression models including treatment group as a categorical predictor and study visit as a repeated measure. Dependent measures included Marks Fear Questionnaire (MFQ), Brief Social Phobia Scale (BSPS), CGI-I, and Sheehan Disability Scale (SDS). We investigated several possible predictors of response to treatment including DSM-IV comorbidity, age, sex, age of onset of GSP, and duration of illness. Patients with later-onset (especially adult-onset) GSP tend to have a better response to treatment than those with earlier-onset GSP. This result generally appears in our analyses as a 2-way interaction, where the association with response is greatest for patients with adult-onset GSP (in contrast to those with child or adolescent onset). This finding is most robust for symptom measures, but is still apparent for the Sheehan measure of disability at work. This advantage for later-onset GSP can be accounted for neither by severity of illness nor by duration of illness. Superior treatment outcome for later-onset GSP may be mediated by the degree of social and family disability.

UR - http://www.scopus.com/inward/record.url?scp=1642579575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1642579575&partnerID=8YFLogxK

U2 - 10.1097/01.jcp.0000104909.75206.6f

DO - 10.1097/01.jcp.0000104909.75206.6f

M3 - Article

C2 - 14709946

AN - SCOPUS:1642579575

VL - 24

SP - 42

EP - 48

JO - Journal of Clinical Psychopharmacology

JF - Journal of Clinical Psychopharmacology

SN - 0271-0749

IS - 1

ER -