Implications of the severity of social phobia

This paper presents a post hoc analysis of a recent large, 12-week, placebo-controlled trial of paroxetine in the treatment of social phobia, which analyzes subgroups of patients classified as suffering from severe (Liebowitz Social Anxiety Scale [LSAS] total score > or = 82, n = 85) or moderate (LSAS total score 52-81, n = 78) social phobia. With respect to the reduction in LSAS total score, the paroxetine-placebo difference was greater in patients in the severe subgroup (20.0, P < 0.001) than those in the moderate subgroup (13.7, P < 0.02). Likewise, for the number of patients rated as 'very much' or 'much' improved according to their Clinical Global Impressions improvement scores, the paroxetine-placebo difference was greater in the severe subgroup (34.2%, P < 0.001) than in the moderate subgroup (29.1%, P < 0.02). In conclusion, paroxetine is effective compared with placebo in both moderate and severe social phobia, and the response is more clear cut in patients with more severe symptoms.