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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2009 September;50(3):277-89


language: English

Social anxiety disorder: an update and future directions

Dalrymple K. L.

Alpert Medical School of Brown University and Rhode Island Hospital, Rhode Island, USA


Social anxiety disorder (SAD) is a highly prevalent psychiatric disorder that often results in significant social, occupational, and academic impairment. Despite its high prevalence, it often is under-recognized, and most individuals with SAD seek treatment for another disorder, most often depression. SAD likely develops from a variety of factors, including genetic and environmental (such as, parenting styles). It has an onset early in life, with a chronic and unremitting course without treatment. It is highly comorbid with other anxiety disorders as well as mood and substance use disorders, and research suggests that SAD tends to have an onset prior to these other comorbid disorders. Despite its significant severity, efficacious treatments for SAD exist including cognitive-behavioral treatments and pharmacotherapy (particularly selective serotonin reuptake inhibitors). Several factors have been examined as predictors of outcome in the cognitive-behavioral treatment of SAD, with depression being the most robust predictor thus far. Prior research also suggests that combined treatment for SAD may not add incremental benefit to either monotherapy, although additional research in this area is needed. Other future directions for research are provided, such as development and examination of new or modified treatments for individuals who do not respond to traditional cognitive-behavioral treatment for SAD, as well as the identification and treatment of SAD in individuals with other psychiatric disorders.

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