J Clin Outcomes Manage
Improving recognition and treatment of social anxiety disorder
Stoddard JA, Lopez ME, Cullen ER
Abstract: Objective: To review the assessment, diagnosis, and treatment of social phobia. Methods: Review of the literature and illustration of concepts via case presentation. Results: Social anxiety disorder, or social phobia, is a chronic disorder that impairs functioning and results in a marked decrease in quality of life. The onset of social phobia typically occurs in early to mid adolescence, making it difficult to establish or maintain relationships at a time when social support is particularly important. A number of assessment measures and modalities can assist clinicians in accurately identifying and diagnosing social anxiety disorder. Depression, other anxiety disorders, and avoidant personality disorder should be considered. Cognitive behavioral therapy (CBT) is the most widely researched treatment for social anxiety disorder and is efficacious in treating individuals suffering from the disorder. While the efficacy of a number of psychotropic medications has been demonstrated for the treatment of social phobia, selective serotonin reuptake inhibitors (SSRIs) and norepinephrine-serotonin reuptake inhibitors (NSRIs) are safer, have fewer side effects than other medications, and may be better first-line pharmacological treatments. Consumers and clinicians should be aware that medication discontinuation often leads to relapse, whereas CBT is more durable over time and may be helpful for relapse prevention. Conclusion: Appropriate and evidence-based assessment, diagnosis, and treatment of social anxiety disorder can improve outcomes for this often disabling but treatable condition.
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