Social Anxiety Disorder

The new england journal o f medicine

NEJM 376
Writer : Falk Leichsenring, D.Sc., and Frank Leweke, Dr.Med.
Publisher : June 8, 2017
Reviewer:
Ismiyati Parhatin (1513010003)
Novia Safitri (1513010006)
 What is the research
purposes?

To give the clinical recommendations for

people with Social Anxiety Disorder.
 Influence factors:
Subject: 1. Genetic and environmental factors
Methods:
Human with social 2. Parenting factors
Case report
anxiety disorder 3. Age factor
4. Neurobiologic factors

Variabel independen: Variabel dependen:

Clinical recommendation Social anciety disorder

Resoning research:
A 26-year-old student have a social anxiety disorder
and how should to managed in this case
 Research procedure
This Journal feature begins with a case a common
clinical problem. The authors write the evidence
supporting and formal guidelines, when they exist.
Than this article ends with the authors’ clinical
recommendations.
Result prosedure
Skenario
A 26-year-old student

Very anxious when giving a presentation,

taking an examination, or meeting an
authority figure

He has palpitations, tremors, blushing, and

sweating

Having few social contacts and avoids going

to parties and making phone calls, but he
feels lonely.

How should this case be managed?

 What is social anxiety disorder???

• An intense fear of social situations in which the person may be

scrutinized by others
DEFINITION • Onset : ± 13 years old

• Increased risk of depressive disorders, substance-use disorders,

and cardiovascular disease
• Genetic and environmental factors explain most of the individual
differences among persons with social anxiety disorder.

• Depends on the patient’s preferences and on clinical judgment.

• CBT was psychotherapy and first line and SSRI was farmakology
TREATMENT fist line
Criteria diagnosis from DSM 5:
Differential Diagnosis
Treatment
psychotherapy

1. Cognitive
behavioral
therapy
2. Short-term
psycho
dynamic
therapy
3. Interpersonal
therapy
4. Mindfulness-
based stress
reduction
 Pharmacotherapies
Sosial Anxiety Disorders Performance Anxiety

1. SSRI (sertraline,
paroxetine, paroxetine CR,
fluvoxamine, escitalopram)
2. SNRI (venlafaxine XR)
3. Benzodiazepine 1. Beta-blocker (propanolol)
(clonazepam) 2. Benzodiazepine
4. Anticonvulsant (pregabalin) (Alprazolam, Lorazepam)
5. MAOI (phenelzine,
moclobemide)
 Conclusion
 Social anxiety disorder is social fears when giving a presentation,
taking an examination, or meeting an authority figure. These
fears were associated with palpitations, tremors, blushing, and
sweating.
 Pharmacotherapy tends to work more quickly, but CBT may have
longer-lasting effects. Thus, if CBT is available, we generally
recommend it in of pharmacotherapy.
 However, if the patient prefers pharmacotherapy or does not
have access to psychotherapy, we would initiate an SSRI at a low
dose .
kelebihnnya
To know how to managed social anxiety
disorder whether using pharmacotherapies or
psycotherapies
 Lack of the jurnal:

Most trials of pharmacotherapeutic agents are short

term and do not include long-term follow up after
treatment has been discontinued.
RCTs (Randomized controlled trials) that assess the
effects of betablockers and benzodiazepines on
performance anxiety are also needed