An examination of syndromal validity and diagnostic subtypes in social phobia and panic disorder.
BACKGROUND
We investigated whether patients with DSM-III-R panic disorder and patients with social phobia could be distinguished on the basis of selected demographic variables and by several commonly used anxiety and phobia rating scales.


METHODS
Sixty-six patients with social phobia and 60 patients with panic disorder (42 with and 18 without agoraphobia) were studied. Subjects completed a battery of self-report measures that assessed phobic fears, avoidance, and related problems.


RESULTS
Social phobic patients showed an earlier age at onset than the panic disorder group, and there was a trend for more social phobics to have never married. Social phobics reported significantly greater levels of social phobic avoidance and distress, fear of negative evaluation, and avoidance of social situations than the panic disorder patients who reported more overall anxiety and rated themselves as significantly more avoidant of situations involving exposure to public places and to blood or injury. Discriminant function analyses showed that social phobic and panic disorder patients can be reliably discriminated on these scales.


CONCLUSIONS
The results of this study lend further support for the validity of the DSM-III-R nosologic distinctions between social phobia and panic disorder. Furthermore, generalized social phobia appears to be remarkably different from discrete social phobia on these measures. This study provides less support for considering panic disorder with agoraphobia to be distinct from panic disorder without agoraphobia.
Gelernter
C S
CS
Section on Anxiety and Affective Disorders, National Institute of Mental Health, Bethesda, Md.
Stein
M B
MB
Tancer
M E
ME
Uhde
T W
TW
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000379:Agoraphobia / Q000145:classification / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D010555:Personality Inventory / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000145:classification / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D009626:Terminology as Topic