Thursday, December 20, 2007

Social Phobia: How Common?

So how common is social phobia? Some varying answers:

1. Is it 7% at any one point in time and 12% over a person’s lifetime?
2. Is it 2% at any one point in time and 6.65% over a person’s lifetime?
3. Is it 1% at any one point in time and 2% over a person’s lifetime?

These estimates are all derived from peer-reviewed epidemiological studies on the topic and it is clear that they vary greatly. Let’s think about social anxiety for a moment…

Social phobia/social anxiety disorder appeared on the mental health scene with a vengeance about a decade ago thanks in large part to a wonderful “educational” campaign by Cohn & Wolfe, a PR firm hired by SmithKlineBeecham to spread the word about this allegedly underrecognized and undertreated condition that was devastating the lives of untold tens of millions across the globe (1, 2, 3).

The 12% lifetime prevalence figure is oft-cited, but it is important to consider that credible evidence has also placed the figure as low as about 2%. Yes, I am aware that the 12% figure is from the U.S. and the 2% figure is from Italy – but does anyone want to argue that Italian and American cultures are so different that social anxiety in these cultures would really differ by a factor of six?

Perhaps someone with more energy can look through these papers (as well as the many other similar epidemiological studies that have been conducted) and take a stab at why the estimates vary so greatly. Might it have something to do with where we set the cutoff? Might it be that the more we label mere shyness as pathology, the higher our rates of social anxiety disorder? Seems that we might want to consider whether a disorder actually causes significant impairment before we call it a disorder, eh?

Social phobia is often listed as the third most common mental disorder (4, 5), but it seems we had better start asking more questions and show more skepticism before blindly accepting that this condition is running rampant.

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