title: Social anxiety disorder as a hidden psychiatric comorbidity among cancer patients.
abstract: OBJECTIVE
  Social anxiety disorder is one of the most popular psychiatric disorders in the general population and is also well known as a very common comorbid psychiatric disorder among patients with major depression. On the other hand, social anxiety disorder has been termed "the neglected anxiety disorder" because its diagnosis is often missed. Furthermore, the potential impact of social anxiety disorder on the psychological distress of cancer patients has not been reported.
  
  
  METHODS
  We encountered two cancer patients with refractory depression after cancer diagnosis, in whom comorbid social anxiety disorder was unexpectedly detected during a subsequent follow-up.
  
  
  RESULTS
  To the best of our knowledge, this is the first report to discuss the potential impact of social anxiety disorder on cancer patients' distress. These two cases may help to improve our understanding of the complicated mental health problems of cancer patients and the potential influence of social anxiety disorder on patients' follow-up medical treatment.
  
  
  CONCLUSIONS
  Comorbid social anxiety disorder should be considered when a cancer patient's depression is resistant to treatment and the existence of communication problems between the patient and the medical staff is suspected.
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan. takechi@med.nagoya-cu.ac.jp
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Toru
authors.initials: T
authors.lastname: Okuyama
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sagawa
authors.forename: Megumi
authors.initials: M
authors.lastname: Uchida
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakaguchi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.forename: Toshiaki A
authors.initials: TA
authors.lastname: Furukawa
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010698:Phobic Disorders / Q000175:diagnosis* / Q000523:psychology; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D002583:Uterine Cervical Neoplasms / Q000523:psychology* / Q000628:therapy