THE IMPACT OF HEALTH-CARE REFORM ON SOCIAL PHOBIA

According to the National Comorbidity Survey, social phobia is the thi rd most frequent psychiatric disorder in the United States. Its lifeti me prevalence rate of 13.3% ranks behind only major depressive episode (17.1%) and alcohol dependence (14.1%). As was the case with depressi on 15 years ago, social phobia has often been trivialized and stigmati zed. For example, some with social phobia may be dismissed as having m ere ''stage fright'' or excessive shyness, while, in fact, social phob ia is a serious mental illness associated with substantial psychosocia l distress, comorbidity, and morbidity. Typical onset of social phobia is in the midteens and often continues throughout an individual's lif etime, leading to severe social and occupational impairment. Several e xcellent, efficacious treatments are available. Access to these treatm ents for social phobia may be more difficult in the future due to mana ged care initiatives and health care reform. Various proposals are now being considered as a part of health care reform that may have signif icant impact on the diagnosis and treatment of social phobia.