Epidemiology and natural course of social fears and social phobia.
OBJECTIVE
To summarize epidemiological studies providing data on prevalence, incidence, comorbidity, natural course, risk factors and consequences of social phobia (SP).


METHODS
Data from cross-sectional studies and prospective longitudinal studies in particular are considered.


RESULTS
These studies portray SP as a frequent mental disorder, which begins typically in early adolescence, and is highly comorbid with other anxiety disorders, as well as secondary depression and substance abuse disorders. Several possible risk factors have already been identified for the onset and unfavorable course of SP; some of them have been tested in prospective longitudinal studies. SP is a chronic disorder when compared with other mental disorders and when subclinical symptomatic levels are considered. Impairment caused by SP is considerable and increases over a patient's life span. The negative impact of SP is not only reflected in subjective well-being and reduced quality of life but also in social role functioning, and it impacts negatively on career progression.


CONCLUSIONS
Prospective longitudinal studies in representative samples drawn from the general population provide information that allows the overall direct and indirect costs of the disorder (treatment costs, disability, social welfare) to be determined, and enables an improvement in long-term care strategies as well as preventive efforts to be established.
Wittchen
H-U
HU
Department of Clinical Psychology and Psychotherapy, Dresden University of Technology, Chemnitzer Str. 46, Dresden, Germany. wittchen@mpipsykl.mpg.de
Fehm
L
L
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002322:Career Mobility; D015897:Comorbidity; D018450:Disease Progression; D005239:Fear; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000453:epidemiology* / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D012919:Social Behavior