Social Anxiety Disorder is not just shyness: A Common but Underdiagnosed Condition

@#Social anxiety disorder (SAD) is a common but unfortunately under-recognised type of anxiety disorder, leading to 80 percent of the patients undertreated. SAD can present a diagnostic challenge to primary care physicians as patients may present only when they start developing psychiatric comorbidities. Recognition and differential diagnosis of SAD is important for primary care physicians as untreated SAD is highly associated with comorbidities and significant functional impairment. Our objective in presenting this case series of SAD is to illustrate the typical and atypical ways SAD can present, including an atypical case that may have been mistaken as a psychotic disorder. We also discuss the differential diagnosis, Etiology and treatment for SAD. SAD often shows good response to medications and psychotherapy. Hence, it is important to recognise and provide appropriate early intervention to prevent the development of comorbidities and improve function.

Specific and social fears in children and adolescents: separating normative fears from problem indicators and phobias

Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.