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An open trial of paroxetine for the "offensive subtype" of taijin kyofusho and social anxiety disorder.

Abstract
The taijin kyofusho (TKS) offensive subtype is thought to be a culture-bound syndrome similar to social anxiety disorder (SAD). In Western countries, such patients would be diagnosed as having delusional disorder, somatic subtype, or body dysmorphic disorder. Recently, open trials for the TKS offensive subtype and a randomized controlled trial for body dysmorphic disorder demonstrated that selective serotonin reuptake inhibitors (SSRIs) might be as effective in TKS as in SAD. This study investigated the efficacy of the SSRI paroxetine in patients with the TKS offensive subtype, both on anxiety and fears, as well as insight. This study was a 12-week open trial using paroxetine in 22 patients with TKS. Subjects were diagnosed based on the original diagnostic criteria for the TKS offensive subtype. Insight regarding TKS symptoms was assessed by the 11th supplement subscale "Insight into obsessions and compulsions" of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The Liebowitz Social Anxiety Scale (LSAS), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Rosenberg's Self-Esteem Scale, and the Interpersonal Distrust subscale of the Eating Disorder Inventory were also administered. Offensive anxiety was assessed by the original TKS offensive anxiety subscale (0-3 points). The primary efficacy variable was the Clinical Global Impression scale (CGI) global improvement item. Nineteen patients completed the study. Forty-seven percent (9/19) were responders to the drug treatment (scoring 2 or less on the CGI). Last observation carried forward (LOCF) analysis (N=22) demonstrated a statistically significant reduction in LSAS total score and offensive anxiety in TKS, and the insight scale score of the Y-BOCS also significantly improved. Interpersonal distrust showed a trend toward improvement.
AuthorsToshihiko Nagata, Irene van Vliet, Hisashi Yamada, Kouhei Kataoka, Toshiya Iketani, Nobuo Kiriike
JournalDepression and anxiety (Depress Anxiety) Vol. 23 Issue 3 Pg. 168-74 ( 2006) ISSN: 1091-4269 [Print] United States
PMID16456863 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Serotonin Uptake Inhibitors
  • Paroxetine
Topics
  • Adult
  • Awareness (drug effects)
  • Cultural Characteristics
  • Delusions (diagnosis, drug therapy, psychology)
  • Fear (drug effects)
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Paroxetine (therapeutic use)
  • Phobic Disorders (diagnosis, drug therapy, psychology)
  • Selective Serotonin Reuptake Inhibitors (therapeutic use)
  • Somatoform Disorders (diagnosis, drug therapy, psychology)
  • Treatment Outcome
  • Trust

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