title: Diagnosing social anxiety disorder in the presence of obesity: implications for a proposed change in DSM-5.
abstract: BACKGROUND
  The proposed draft of the DSM-5 from the Anxiety Disorder Workgroup recommends allowing the diagnosis of social anxiety disorder (SAD) in individuals with medical conditions, if the anxiety is considered to be excessive. Although prior research has examined diagnosing SAD in individuals with stuttering, such research has not yet been conducted in obese individuals.
  
  
  METHODS
  This study compared demographic and clinical characteristics of obese individuals diagnosed with DSM-IV SAD (n = 135), modified SAD (clinically significant social anxiety related to weight only; n = 40), and a group of obese individuals with no history of psychiatric disorders (n = 616). All participants were seeking psychiatric clearance for bariatric surgery and completed a comprehensive diagnostic interview.
  
  
  RESULTS
  The two social anxiety groups differed from the no disorder group on adolescent and past 5 years social functioning, and overall current functioning. Individuals with modified SAD had a later onset of their social anxiety, yet reported greater impairment in social life and distress about their social anxiety compared to the DSM-IV SAD group.
  
  
  CONCLUSIONS
  Although both of the social anxiety groups differed from the no disorder group on social and overall functioning, there were few differences between those with DSM-IV SAD and modified SAD. This suggests that obese individuals with social anxiety related to weight only may experience comparable severity of anxiety to those with DSM-IV SAD, and supports adoption of the DSM-5 Workgroup's recommendation to change criterion H.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI 02905, USA. kristy_dalrymple@brown.edu
authors.forename: Kristy L
authors.initials: KL
authors.lastname: Dalrymple
authors.forename: Janine
authors.initials: J
authors.lastname: Galione
authors.forename: Joshua
authors.initials: J
authors.lastname: Hrabosky
authors.forename: Iwona
authors.initials: I
authors.lastname: Chelminski
authors.forename: Diane
authors.initials: D
authors.lastname: Young
authors.forename: Erin
authors.initials: E
authors.lastname: O'Brien
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
mesh_terms: D000041:Absenteeism; D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D010552:Personality Assessment / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology*; D011300:Preoperative Care; D011594:Psychometrics; D012959:Socioeconomic Factors