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April 1992

Social Phobia: Comorbidity and Morbidity in an Epidemiologic Sample

Author Affiliations

From the Departments of Therapeutics (Drs Schneier and Liebowitz) and Clinical and Genetic Epidemiology (Drs Johnson and Weissman and Mr Hornig), New York State Psychiatric Institute, New York; and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY (Drs Schneier, Johnson, Liebowitz, and Weissman and Mr Hornig).

Arch Gen Psychiatry. 1992;49(4):282-288. doi:10.1001/archpsyc.1992.01820040034004

• Selected sociodemographic and clinical features of social phobia were assessed in four US communities among more than 13 000 adults from the Epidemiologic Catchment Area study. Rates of social phobia were highest among women and persons who were younger (age, 18 to 29 years), less educated, single, and of lower socioeconomic class. Mean age at onset was 15.5 years, and first onsets after the age of 25 years were uncommon. Lifetime major comorbid disorders were present in 69% of subjects with social phobia and usually had onset after social phobia. When compared with persons with no psychiatric disorder, uncomplicated social phobia was associated with increased rates of suicidal ideation, financial dependency, and having sought medical treatment, but was not associated with higher rates of having made a suicide attempt or having sought treatment from a mental health professional. An increase in suicide attempts was found among subjects with social phobia overall, but this increase was mainly attributable to comorbid cases. Social phobia, in the absence of comorbidity, was associated with distress and impairment, yet was rarely treated by mental health professionals. The findings are compared and contrasted with prior reports from clinical samples.

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