Subtypes of social phobia and comorbidity with depression and other anxiety disorders

Epidemiological studies have identified two subtypes of social phobia: spea king-only social phobia which is characterized by the fear of public speaki ng situations and complex social phobia which is characterized by the fear of multiple social situations. Speaking-only social phobia most closely cor responds to the DSM-IV's 'nongeneralized social phobia' while complex socia l phobia resembles 'generalized social phobia'. In contrast to the speaking -only social phobia, the complex form is usually more disabling, familial a nd longer-lasting. In addition, the complex form has a lower chance of spon taneous recovery and carries a higher risk of comorbidity and impairment. O verall, both types of social phobia tend to be underdiagnosed and under-tre ated. Effective treatments which can manage not only complex social phobia, but also its spectrum of comorbid conditions, are required. (C) 1998 Elsev ier Science B.V. All rights reserved.