Intended for healthcare professionals


Social anxiety disorder

BMJ 2003; 327 doi: (Published 04 September 2003) Cite this as: BMJ 2003;327:515
  1. Franklin R Schneier, associate professor of clinical psychiatry (
  1. Department of Psychiatry, Columbia University, New York State Psychiatric Institute, Unit 69, 1051 Riverside Drive, New York NY 10032, USA

    Is common, underdiagnosed, impairing, and treatable

    The hallmark of social anxiety disorder is extreme and persistent fear of embarrassment and humiliation.1 People with this condition (which is also known as social phobia) often avoid participating in social and public activities, such as public speaking, social gatherings, or meetings. Whereas normative social anxiety may serve to focus attention and prevent inappropriate behaviour, the intense symptoms of social anxiety disorder, by definition, interfere with functioning or cause marked distress.

    Differentiation of social anxiety disorder from other phobic disorders was first validated by its characteristic age of onset in the mid-teens and greater ratio of men to women.2 Although once believed to be uncommon, social anxiety disorder was found to be the third most prevalent psychiatric disorder in the US national comorbidity survey,3 and most studies in Europe and North America have found a 7-12% lifetime prevalence in the community and higher rates in primary care samples.4

    Despite increasing recognition of social anxiety disorder as common, impairing, yet treatable, it often remains undiagnosed.4 …

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