The effect of depression on treatment outcome in social anxiety disorder: an individual-level meta-analysis

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Social anxiety disorder (SAD) is highly comorbid with depression. In the present meta-analysis, we conducted the first individual-level examination of the association between pre-treatment depression and improvement in social anxiety symptoms during treatment. We identified eligible studies on cognitive behavior therapy (CBT) and pharmacotherapy for SAD and contacted authors to obtain individual-level data. We obtained these data from 41 studies, including 46 treatment conditions (n = 4,381). Our results showed that individuals who had high levels of depression at pre-treatment experienced greater decreases in social anxiety symptoms from pre- to post-treatment, but not at follow-up. When analyzing treatment modalities (individual CBT, group CBT, internet-delivered CBT, and pharmacotherapy), we found that depressive symptoms were associated with better post-treatment outcomes for individual CBT and internet-delivered CBT, but not for pharmacotherapy or group CBT. Our findings suggest that depression does not negatively affect treatment outcome in SAD and may even lead to improved outcomes in some treatment formats. Clinical implications of these findings are discussed.

Original languageEnglish
Pages (from-to)185-216
Number of pages32
JournalCognitive Behaviour Therapy
Issue number3
StatePublished - 2022

Bibliographical note

Publisher Copyright:
© 2021 Swedish Association for Behaviour Therapy.


  • Social anxiety disorder
  • cognitive behavior therapy
  • depression
  • individual-level meta-analysis
  • pharmacotherapy

ASJC Scopus subject areas

  • Clinical Psychology


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