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Social Anxiety Disorder: More Than Just a Little Shyness

Primary Care Companion J Clin Psychiatry 2001;3(1):4-9

Social anxiety is defined as a "marked and persistent fear of social or performance situations" and includes such symptoms as sweating, palpitations, shaking, and respiratory distress. Social anxiety is fairly common, occurring in as much as 13% of the population, and can be extremely disabling. It can be either specific (confined to 1 or 2 performance situations) or generalized, and can be diagnosed with a scale-based questionnaire. Social anxiety may coexist with other disorders, such as depression and dysthymia. The differential diagnosis for social anxiety includes panic disorder, agoraphobia, atypical depression, and body dysmorphic disorder. Treatment for social anxiety can be quite effective and consists of psychotherapy, pharmacotherapy (including such medications as beta-blockers, anxiolytics, antidepressants, and anticonvulsants), or a combination. This article details the prevalence, onset, disease impact, and etiology of social anxiety. Specific treatments, including both psychotherapy and pharmacotherapy, are presented in detail, along with other treatment considerations, such as comorbidity.