Social phobia: diagnosis, severity and implications for treatment

Social phobia has a direct effect on the ability of the individual to inter act with others in social or work situations and as a result is associated with a high level of dysfunction. The level of impairment is as severe as t hat found in other chronic disorders such as depression and is increased by a cascade of comorbidity, which complicates management. Efficacy in social phobia was reported with the MAOIs and this led to the investigation of re versible inhibitors of monoamine oxidase - A (RIMA) which offer a safer alt ernative. The efficacy of moclobemide has been shown in social phobia and t he effect is more clear cut in patients with more severe symptoms. The bett er effect in severe social phobia has also been reported with the SSRI paro xetine. Effective treatment of social phobia appears to be able to overcome the substantial chronicity of illness which is frequent in sufferers. The introduction of these treatments should encourage people with social phobia to seek medical help for this hitherto much neglected disorder.