This review covers three themes of research that brought fresh data useful for clinical practice in a handicapping
anxiety disorder: social phobia. Recent findings deriving from basic biological research, new forms of psychological
therapies, and recent psychopharmacology controlled trials are reviewed.
RECENT FINDINGS: The basic neuroimaging research suggests that greater activation of the amygdala to novel versus familiar faces may be an underlying trait marker for
social phobia.
Social phobia may represent a phenotype that expresses a genetically driven trait of social withdrawal, which may be related to infantile inhibited temperament (Kagan's syndrome). The development of virtual reality therapy as therapeutic tool for
social phobia appeared promising in one controlled, but not randomized, study. A controlled study suggests that
social phobias in children can be effectively treated with cognitive behavioural
therapy. This represents an extension of the work done with adults.
Venlafaxine appears an effective short-term treatment for
social anxiety disorder in two controlled studies. A new compound,
pregabalin, appeared clearly effective in a positive controlled study. This trial marks the advent of a new pharmacological lineage for
social phobia. Both
venlafaxine and
pregabalin, however, have been studied in short-term studies. Longer follow-up and
relapse prevention studies are warranted.
SUMMARY: Neuroimaging research points to a temperamental basis for
social phobia. Virtual reality therapy is an emerging tool to carry out exposure treatment. Group cognitive behavioural
therapy can be extended successfully to children.
Venlafaxine and
pregabalin have a proven short-term effectiveness in
social phobia.