Comorbidities in social phobia

In a sample of 2096 consecutive primary care patients recruited in the Paris region, social phobia was a highly prevalent disorder (5.1%). The most frequent comorbid condition was depressive episode, which affected 70% of patients with social phobia of early onset (at less than 15 years of age), while the highest association was with agoraphobia (odds ratio 10.4). No association was observed with generalized anxiety disorder. Alcohol abuse and suicidal ideation and attempts are also commonly associated with social phobia. However, when patients presented to a general practitioner with comorbid depression present, 76% were recognized as cases (though only 11% were identified as having an anxiety disorder), but in the absence of depression, only 46% were identified as cases. Given the degree of disability caused by social phobia, there is an obvious need for improved education of both doctors and patients regarding its status as a disorder, and its treatability.