Subtypes of social phobia and comorbidity with depression and other anxiety disorders

Epidemiological studies have identified two subtypes of social phobia: speaking-only social phobia which is characterized by the fear of public speaking situations and complex social phobia which is characterized by the fear of multiple social situations. Speaking-only social phobia most closely corresponds to the DSM-IV's 'nongeneralized social phobia' while complex social phobia resembles 'generalized social phobia'. In contrast to the speaking-only social phobia, the complex form is usually more disabling, familial and longer-lasting. In addition, the complex form has a lower chance of spontaneous recovery and carries a higher risk of comorbidity and impairment. Overall, both types of social phobia tend to be underdiagnosed and under-treated. Effective treatments which can manage not only complex social phobia, but also its spectrum of comorbid conditions, are required.