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Physical disability and social phobia

E L Oberlander1, F R Schneier, M R Liebowitz

  • 1College of Physicians and Surgeons, Columbia University, New York, New York.

Journal of Clinical Psychopharmacology
|April 1, 1994
PubMed
Summary
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This study suggests phenelzine effectively treats social anxiety secondary to physical conditions, challenging current diagnostic exclusions. This finding offers new treatment options for overlooked patients.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • The Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) excludes social anxiety secondary to Axis III (physical) conditions from the social phobia diagnosis.
  • This exclusion lacks empirical support and overlooks a potentially treatable patient group.

Observation:

  • Eight clinical cases of patients with disfiguring or disabling physical conditions experienced significant secondary social anxiety.
  • These patients exhibited excessive anxiety levels directly related to their physical ailments.

Findings:

  • All eight patients showed a positive response to phenelzine, a monoamine oxidase inhibitor (MAOI).
  • Phenelzine treatment allowed patients to live with reduced inhibition and fewer restrictions.

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  • The medication response pattern mirrored that of generalized or DSM-III-R social phobics.

    • Implications:

    • Phenelzine represents a novel treatment application for social anxiety secondary to physical conditions.
    • The positive treatment response suggests reconsidering the Axis III exclusion in future diagnostic criteria (e.g., DSM-IV).
    • This research supports the inclusion of such cases within the broader definition of social phobia.