Social anxiety disorder

Last reviewed: 30 May 2022
Last updated: 24 Jun 2022

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
More key diagnostic factors

Other diagnostic factors

  • post-event processing
  • attentional biases
  • social skills deficits
  • crying, tantrums, or "freezing
  • selective mutism
Other diagnostic factors

Risk factors

  • psychiatric comorbidity (e.g., anxiety, mood, and substance-use disorders)
  • genetic
  • temperamental factors
  • parenting style
  • psychological disorder
  • life stressors
  • environmental factors
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • blood glucose
  • serum thyroid-stimulating hormone
  • toxicology screen (urine and blood)
More investigations to consider

Treatment algorithm

ONGOING

adults: no comorbidity

adults: comorbidities

children and adolescents

Contributors

Authors

Craig N. Sawchuk, PhD
Craig N. Sawchuk

Professor

Department of Psychiatry and Psychology

Mayo Clinic

Rochester

MN

Disclosures

CNS declares that he has no competing interests.

Jason P. Veitengruber, MD
Jason P. Veitengruber

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
Bunmi O. Olatunji

Professor

Department of Psychological Sciences

Vanderbilt University

Nashville

TN

Disclosures

BOO declares that he has no competing interests.

Stacy Shaw Welch, PhD
Stacy Shaw Welch

Director

Anxiety and Stress Reduction Center of Seattle

University of Washington

Seattle

WA

Disclosures

SSW declares that she has no competing interests.

Peer reviewers

Richard P. Swinson, MD, FRCPC, FRCPsych

Emeritus Professor

Medical Director

Anxiety Treatment and Research Centre

McMaster University and St Joseph’s Hospital

Hamilton

Canada

Disclosures

RPS declares that he has no competing interests.

Jeffrey M. Lohr, PhD

Professor

Department of Psychology

University of Arkansas

Fayetteville

AR

Disclosures

JML declares that he has no competing interests.

David F. Tolin, PhD

Professor

Institute of Living

Yale University

New Haven

CT

Disclosures

DFT declares that he has no competing interests.

David Baldwin, MD

Professor of Psychiatry

University of Southampton

Southampton

UK

Disclosures

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.

  • Differentials

    • Phobias
    • Panic disorder
    • Agoraphobia
    More Differentials
  • Guidelines

    • Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR)
    • Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders
    More Guidelines
  • Patient leaflets

    Anxiety

    Panic attacks

    More Patient leaflets
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