Social anxiety disorder in primary care.
OBJECTIVE
To examine the prevalence, comorbidity, disability and mental health treatment associated with social anxiety disorder (SAD) in primary care, and to determine whether patients with SAD avoid seeking help from their primary care providers.


METHODS
We analyzed data from a health survey conducted on a systematic sample of patients. Data were then cross-linked to the practice's automated database in order to compare primary health care utilization by patients with SAD to that of patients with other psychiatric disorders and well controls.


METHODS
Urban primary care practice at a teaching hospital.


METHODS
A systematic sample (n=207) of primary care patients.


RESULTS
Patients were interviewed by mental health professionals using the Composite International Diagnostic Interview. Lifetime prevalence of SAD was 5.7%. Substance use disorders were far more common among patients with SAD than patients with other psychiatric disorders (33.3% vs. 3.3%, P=.01). Social anxiety disorder patients were functionally impaired and made fewer primary care visits per year (mean 4.1) compared to patients with other psychiatric disorders (mean 6.9; P=.016) or well controls (mean 6.4; P=.031); 41.7% reported receiving mental health treatment in the past year.


CONCLUSIONS
Patients with SAD made fewer primary care visits compared to patients with other psychiatric disorders and well controls. These results, together with the high prevalence of substance use in SAD, and the finding that less than one half received past year mental health treatment, suggest substantial unmet need for care and are especially important in view of available effective treatments for SAD.
Gross
Raz
R
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. rg547@columbia.edu
Olfson
Mark
M
Gameroff
Marc J
MJ
Shea
Steven
S
Feder
Adriana
A
Lantigua
Rafael
R
Fuentes
Milton
M
Weissman
Myrna M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006784:Hospitals, Teaching; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data