Social anxiety disorder
Summary
Definition
History and exam
Key diagnostic factors
- history of psychiatric comorbidity
- positive family history of social anxiety
- anticipatory anxiety and worry
- tachycardia
- hyperventilation
- sweating
- flushing
- muscle tension
Other diagnostic factors
- post-event processing
- attentional biases
- social skills deficits
- crying, tantrums, or "freezing"
- selective mutism
Risk factors
- psychiatric comorbidity (e.g., anxiety, mood, and substance-use disorders)
- genetic
- temperamental factors
- parenting style
- psychological disorder
- life stressors
- environmental factors
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- blood glucose
- serum thyroid-stimulating hormone
- toxicology screen (urine and blood)
Treatment algorithm
adults: no comorbidity
adults: comorbidities
children and adolescents
Contributors
Authors
Craig N. Sawchuk, PhD
Professor
Department of Psychiatry and Psychology
Mayo Clinic
Rochester
MN
Disclosures
CNS declares that he has no competing interests.
Jason P. Veitengruber, MD
Associate Professor
Department of Psychiatry and Behavioral Sciences
University of Washington School of Medicine
Seattle
WA
Disclosures
JPV is an author of a reference cited in this topic.
Bunmi O. Olatunji, PhD
Professor
Department of Psychological Sciences
Vanderbilt University
Nashville
TN
Divulgaciones
BOO declares that he has no competing interests.
Stacy Shaw Welch, PhD
Director
Anxiety and Stress Reduction Center of Seattle
University of Washington
Seattle
WA
Divulgaciones
SSW declares that she has no competing interests.
Revisores por pares
Stefan G. Hofmann, PhD
Alexander von Humboldt Professor
Department of Psychology
Philipps University Marburg
Germany
Divulgaciones
SGH is an author of a number of references cited in this topic.
Fallon R. Goodman, PhD
Assistant Professor of Psychology
George Washington University
Washington
DC
Divulgaciones
FRG declares that she has no competing interests.
Richard P. Swinson, MD, FRCPC, FRCPsych
Emeritus Professor
Medical Director
Anxiety Treatment and Research Centre
McMaster University and St Joseph’s Hospital
Hamilton
Canada
Divulgaciones
RPS declares that he has no competing interests.
David Baldwin, MD
Professor of Psychiatry
University of Southampton
Southampton
UK
Divulgaciones
DB has acted as a consultant for and held research grants from Cephalon, Eli Lilly, GSK, Lundbeck, Organon, Pfizer, Pharmacia, Roche, and Wyeth and has also acted as a consultant to Asahi, AstraZeneca, Grunenthal, Pierre Fabre, Servier, Sumitomo, and Wyeth. He has accepted paid speaking engagements in industry-supported satellite symposia and is co-author of the BAP evidence-based guidelines on the treatment of anxiety disorders. He is also a Medical Patron of Anxiety UK.
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
National Institute for Health and Care Excellence. Social anxiety disorder: recognition, assessment and treatment. May 2013 [internet publication].Texto completo
Katzman MA, Bleau P, Blier P, et al; Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14(suppl 1):S1.Texto completo Resumen
Williams T, Hattingh CJ, Kariuki CM, et al. Pharmacotherapy for social anxiety disorder (SAnD). Cochrane Database Sys Rev. 2017 Oct 19;(10):CD001206.Texto completo Resumen
Schaffer A, McIntosh D, Goldstein BI, et al. The CANMAT task force recommendations for the management of patients with mood disorders and comorbid anxiety disorders. Ann Clin Psychiatry. 2012 Feb;24(1):6-22. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Phobias
- Panic disorder
- Agoraphobia
Más DiferencialesGuías de práctica clínica
- Anxiety and depression in children and youth: diagnosis and treatment
- WFSBP guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders- version 3. part I: anxiety disorders
Más Guías de práctica clínicaFolletos para el paciente
Anxiety
Panic attacks
Más Folletos para el paciente
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