Social Phobia Effects on the Patients

Patients with SP may experience extreme fear and anxiety when encountering simple social or performance situations easily negotiated by most people. Due to the severe and chronic pattern of social phobia, patients may experience significant disruption to normal functioning, personal relationships, social interactions, educational achievement, and professional development. Patients with SP often fear that others will find them anxious, weak, “crazy,” or stupid in social or performance situations. Having a heightened awareness of the physical signs (blushing, sweating, palpitations, gastrointestinal distress) of their own anxiety, they fear that others will notice, judge them, and think less of them. This fear often results in extreme anxiety in anticipation of an activity, or in the avoidance of an activity.  Adults with SP realize that their fear is excessive or unreasonable. Children with social phobia, however, may not realize that their symptoms are excessive.

1. SP is the third most common psychiatric disorder, following major depressive disorder and alcohol dependence. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), reports a lifetime prevalence rate for social phobia from 3% to 13%. Patients with SP often suffer from comorbid depression, and may abuse alcohol or drugs in an attempt to reduce their anxiety in feared situations. The majority of patients with SP fear more than one type of social situation; this is referred to as generalized social phobia.
2. Despite its high prevalence, SP is often underreported, underrecognized, and under treated. Diagnosing social phobia can be challenging: common symptoms appear across the spectrum of anxiety disorders, which can make diagnosis difficult.
3. A range of pharmacologic and non-pharmacologic options is currently used for treatment of SP. Selective serotonin reuptake inhibitors (SSRIs) have become the pharmacologic treatment of choice because of their favorable efficacy, safety and tolerability profile, and lack of abuse potential. SSRIs have been recommended as first-line therapy in the treatment of SP by the International Consensus Group on Depression and Anxiety.