[Social phobia - the blind spot: infrequently diagnosed, highly complex, and a predictor for unfavourable therapy outcomes?].
OBJECTIVE
The objectives of the study were to examine (1) whether patients with social phobia report higher symptom load at the beginning and at the end of treatment and 1 year after treatment; and (2) whether the presence of social phobia is a factor that influences the course of treatment.


METHODS
613 patients from a university hospital for psychosomatic medicine filled out questionnaires assessing symptom load (SCL 90-R, KOPS), physical symptoms, psychological and social impairment (KOPS), and depression (BDI). Social phobia was diagnosed based on a standardized diagnostic interview.


RESULTS
25%of the patients suffered from social phobia. They had significantly more concurrent mental disorders (4.18 vs. 2.41) and a higher symptom load than patients suffering from other mental disorders. They reported more physical complaints and depression and felt more impaired psychologically as well as socially. Even though both groups of patients profited from the treatment, compared to other patients, social phobia patients still had higher symptom load, impairment, and depression scores at the end of treatment and even at the follow-up 1 year after treatment.


CONCLUSIONS
Social phobia is a severe disorder in which concurrent disorders frequently cause a high level of distress and impairment. These patients may benefit more from longer courses of treatment and/or disorder-specific treatment elements. Diagnostic and therapy approaches tailored to the generalized type of social anxiety are discussed.
Pöhlmann
Karin
K
Universitätsklinik für Psychotherapie und Psychosomatik, Technische Universität Dresden, Fetscherstr. 74, D-01307 Dresden, Germany. Karin.Poehlmann@tu-dresden.de
Döbbel
Susanne
S
Löffler
Sabine
S
Israel
Matthias
M
Joraschky
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010555:Personality Inventory; D010698:Phobic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D011379:Prognosis; D011575:Psychoanalytic Therapy; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D012803:Sick Role; D012917:Social Adjustment; D016896:Treatment Outcome; D055815:Young Adult