Treating patients suffering from a social phobia with a form of psychotherapy may remove impairments in the key brain structures that are involved in processing and regulating emotions, researchers suggested.

Cognitive behavioural therapy (CBT) is a form of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behaviour patterns or treat mood disorders such as depression. "Psychotherapy normalises brain changes associated with social anxiety disorder," said Annette Bruhl from the University Hospital of Psychiatry Zurich (PUK).

Nearly one in 10 people are affected by social anxiety disorder -- defined as when fears and anxiety in social situations significantly impair everyday life and cause intense suffering. For example, talking in front of a larger group can be one typical feared situation.

The findings showed that in such patients, the frontal and lateral brain areas -- where excessive anxiety is regulated -- are impaired.  "We were able to show that structural changes occur in brain areas linked to self control and emotion regulation," Bruhl added.

But, strategies by CBT that are aimed at regulating emotions can restore the balance between cortical and subcortical brain areas.  The more successful the treatment, the stronger brain changes, the researchers said, in the paper published in the journal Molecular Psychiatry.

In addition, CBT treatment also led to better interconnectivity between brain areas involved in processing emotions.  For the study, the team investigated structural brain changes in patients suffering from social anxiety disorder after a specific ten-week course of CBT.  Using magnetic resonance imaging the participants' brains were examined before and after CBT.