Abstract：
BACKGROUND: Patients with social anxiety (SAD) and comorbid avoidant personality disorder (AVPD) are severely impaired. Group cognitive behavioral therapy (GCBT) is considered an effective treatment for SAD. More knowledge on treatment of SAD with comorbid AVPD is needed. Schema therapy, developed for personality and chronic mental disorders, may be a promising treatment.
METHODS: We conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index).
RESULTS: Intention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST.
CONCLUSIONS: GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.
METHODS: We conducted a randomized controlled trial in an outpatient population (n = 154) with both SAD and AVPD. Group Schema Therapy (GST) and GCBT were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and manifestations of AVPD (Avoidant Personality Disorder Severity Index).
RESULTS: Intention-to-treat analysis showed no significant differences between treatments at 3 months post-treatment and one-year follow-up. Both modalities led to significant and substantial improvements. No significant between-differences were found in depressive symptoms (Inventory of Depressive Symptoms) and quality of life (World Health Organization Quality of Life-BREF). Per-protocol analysis showed similar outcomes and no significant differences in recovery from SAD and AVPD. Significantly more patients completed GST.
CONCLUSIONS: GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment retention in ST indicates ST is more acceptable than GCBT. Future studies should focus on enhancing treatment effects and improving retention to GCBT.
摘要：
背景：社交焦虑（SAD）和共病回避型人格障碍（AVPD）患者严重受损。团体认知行为疗法（GCBT）被认为是SAD的有效治疗方法。需要更多关于合并AVPD的SAD治疗的知识。图式疗法,为人格和慢性精神障碍而发展，可能是一种有希望的治疗方法。
方法：我们在患有SAD和AVPD的门诊人群（n=154）中进行了一项随机对照试验。比较了团体图式治疗（GST）和GCBT的SAD症状（Liebowitz社交焦虑量表）和AVPD（回避性人格障碍严重程度指数）的表现。
结果：意向治疗分析显示，在治疗后3个月和1年随访时，治疗之间没有显着差异。这两种方式都带来了重大和实质性的改进。在抑郁症状（抑郁症状清单）和生活质量（世界卫生组织生活质量-BREF）中没有发现显着差异。按照方案分析显示类似的结果，从SAD和AVPD的恢复没有显着差异。更多的患者完成了GST。
结论：GST和GCBT是SAD合并AVPD的有价值的治疗方法。ST中较高的治疗保留表明ST比GCBT更可接受。未来的研究应集中在提高治疗效果和改善对GCBT的保留。
方法：我们在患有SAD和AVPD的门诊人群（n=154）中进行了一项随机对照试验。比较了团体图式治疗（GST）和GCBT的SAD症状（Liebowitz社交焦虑量表）和AVPD（回避性人格障碍严重程度指数）的表现。
结果：意向治疗分析显示，在治疗后3个月和1年随访时，治疗之间没有显着差异。这两种方式都带来了重大和实质性的改进。在抑郁症状（抑郁症状清单）和生活质量（世界卫生组织生活质量-BREF）中没有发现显着差异。按照方案分析显示类似的结果，从SAD和AVPD的恢复没有显着差异。更多的患者完成了GST。
结论：GST和GCBT是SAD合并AVPD的有价值的治疗方法。ST中较高的治疗保留表明ST比GCBT更可接受。未来的研究应集中在提高治疗效果和改善对GCBT的保留。
