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Social Phobia (or Social Anxiety Disorder)Social phobia (also known as social anxiety disorder) is characterized by an intense and persistent fear of being scrutinized or evaluated by other people. The anxiety symptoms are restricted to, or predominate in, the feared situations or contemplation of the feared situations. The patient avoids such social situations, such as eating in public, writing in the presence of others, conversing with strangers and using public toilets due to a fear of being ridiculed or humiliated. Those with the disorder have a marked fear of being the focus of attention, or fear of behaving in a way that will be embarrassing or humiliating. In addition to more typical anxiety symptoms, at least one of the following must be present:
There are two sub-types of social phobia:
Social phobia usually begins in childhood or adolescence (about 90% before the age of 20). People with social phobia are less likely to marry and more likely to divorce than the general population. The prevalence is highest in people with a low socioeconomic status, probably reflecting the lower educational attainment and restricted career progression of affected individuals. Until recently the condition was relatively unknown. The findings of the National Comorbidity Survey in the United States suggest that the 1-year prevalence among people aged 15–54 years is almost 8%, and the lifetime risk was calculated to be as high as 13.3%1. The disorder is more common in women than in men. There is a significant comorbidity with other disorders and also a significantly increased risk of suicide attempts. Patients with ‘pure’ social phobia are relatively uncommon in clinical settings. Social Phobia and Panic DisorderSocial phobia can be confused with panic disorder. In social phobia, panic attacks are restricted to feared social situations (or anticipation of those situations), whereas in panic disorder they occur unexpectedly in social encounters or when alone. In social phobia, patients fear appearing foolish and awkward, whereas in panic disorder patients fear losing control or death. In panic disorder, patients can enjoy social encounters when accompanied by a trusted friend; in social phobia, the presence of a friend or relative makes little difference. NOTE: The avoidance of social situations can occur as a result of concerns about medical conditions, such as Parkinson’s disease, benign essential tremor, stuttering, obesity and burns, but this should not be confused with social phobia. |
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