Disability and quality of life in pure and comorbid social phobia - Findings from a controlled study

Social phobia is increasingly recognized as a prevalent and socially impair ing mental disorder. However, little data is available regarding the genera l and disease-specific impairments and disabilities associated with social phobia. Furthermore, most studies have not controlled for the confounding e ffects of comorbid conditions. This study investigates: (a) the generic quality of life; (b) work producti vity; and, (c) various other disorder-specific social impairments in curren t Gases with pure (n = 65), comorbid (n = Sl)and subthreshold (n = 34) DSM- IV social phobia as compared to controls with no social phobia (subjects wi th a history of herpes infections). Social phobia cases reported a mean illness duration of 22.9 years with ons et in childhood or adolescence. current quality of life; as assessed by the SF-36, was significantly reduced in all social phobia groups, particularly in the scales measuring vitality, general health, mental health, role limi tations due to emotional health, and social functioning. Comorbid cases rev ealed more severe reductions than pure and subthreshold social phobics. Fin dings from the Liebowitz self-rated disability scale indicated that: (a) so cial phobia affects most areas of life, hut in particular education, career , and romantic relationship; (b) the presence of past and current comorbid conditions increases the frequency of disease-specific impairments, and, (c ) subthreshold social phobia revealed slightly lower overall impairments th an comorbid social phobics. Past week work productivity of social phobics w as significantly diminished as indicated by: (a) a three-fold higher rate o f unemployed cases; (b) elevated rates of work hours missed due to social p hobia problems; and, (c) a reduced work performance. Overall, these findings underline that social phobia in our sample of adult s, whether comorbid, subthreshold, or pure was a persisting and impairing c ondition, resulting in considerable subjective suffering and negative impac t on work performance and social relationships. The current disabilities an d impairments were usually less pronounced than in the past, presumably due to adaptive behaviors in life style of the respondents. Data also confirme d that social phobia is poorly recognized and rarely treated by the mental health system. (C) 1999 Elsevier, Paris.