Effectiveness of selective serotonin reuptake inhibitors in inpatients with selective mutism compared to social anxiety disorder: an observational study
Abstract
Selective Mutism (SM) is a rare childhood anxiety disorder characterized by a persistent inability to speak in specific social settings despite adequate speaking ability in others, sharing etiological and clinical overlap with Social Anxiety Disorder (SAD). While evidence for pharmacological treatment in SM is limited, selective serotonin reuptake inhibitors (SSRIs) have demonstrated potential efficacy, but studies on effectiveness in routine clinical practice are lacking. This single-center, retrospective observational study analysed data from 2011 to 2021 on children aged 4-14 years with SM or SAD treated as inpatients at a German university hospital. The mean age at admission was 11.9 years in both groups. Using propensity score matching and statistical modelling, we compared SSRI prescription patterns, dosage, and duration of inpatient/day-care treatment (DOT) between groups. In the SM group, we additionally tested for differences in speaking pattern at discharge comparing children with and without SSRI medication. SSRI treatment was more frequent in SM (75.4%) than in SAD (55.0%, p = 0.011). Adjusted for pattern of additional internalizing, externalizing and specific developmental disorders, no main effects of group (SM versus SAD), nor of SSRI treatment or dosage between and across groups were found on DOT. In the SM group, SSRI treatment was associated with more strongly improved speaking pattern at discharge compared to treatment without SSRI (p = 0.009). Results are…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.