Comorbidity in social anxiety disorder: impact on disease burden and management

Social anxiety disorder is a chronic, disabling disorder in which patients suffer with considerable morbidity that, more often than not, precedes the development of other psychiatric disorders. The development of comorbidity adds to the severity of the disorder, increases the risk of suicide attempts, and increases the overall burden of the disease for both the patient (greater disability) and the health care service (greater use of medical services). Comorbidity in social anxiety disorder may result in one good thing: increased recognition and treatment, because in the absence of comorbidity the level of recognition of the disorder is very low. However, the disorder is rarely recognized correctly and, consequently, patients are often offered inappropriate treatments. Given the degree of disability caused by social anxiety disorder, whether "pure" or comorbid, there is a need for improved education of both doctors and patients regarding its status as a disorder and its treatment.