An eight-year longitudinal comparison of clinical course and characteristics of social phobia among men and women

Objective: Social phobia is a chronic disorder with a higher prevalence amo ng women than men, Data from an eight-year longitudinal study were analyzed to investigate the course of social phobia and to explore potential sex di fferences in the course and characteristics of the illness, Methods: Data w ere analyzed from the Harvard/Brown Anxiety Research Program, a naturalisti c, observational study begun in 1989 in which patients with social phobia a re assessed every six to 12 months. Treatment was observed but not prescrib ed by the program personnel, Data on comorbidity, remission, and health-rel ated quality of life were collected for 176 patients with social phobia. Re sults: Only 38 percent of women and 32 percent of men experienced a complet e remission during the eight-year study period, a difference that was not s ignificant. A larger proportion of women than men had the generalized form of social phobia, although the difference was not significant. Women were m ore likely to have concurrent agoraphobia, and men had a higher rate of com orbid substance use disorders. Social phobia had a more chronic course amon g women who had low Global Assessment of Functioning scores and a history o f suicide attempts at baseline than among men who had these characteristics . Health-related quality of life was similar for both men and women, except that women were slightly but significantly more impaired in household func tioning. Conclusions: The chronicity of social phobia was striking for both men and women. Although remission rates did not differ significantly betwe en men and women, clinicians should. be alert to the fact that women with p oor baseline functioning and a history of suicide attempts have the greates t chronicity of illness.