Social Psychiatry and Psychiatric Epidemiology

, Volume 43, Issue 4, pp 257–265

Social anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population

  • Lydia Fehm
  • Katja Beesdo
  • Frank Jacobi
  • Agnes Fiedler
ORIGINAL PAPER

Abstract

Background

There is a lack of data systematically describing subthreshold expressions of social anxiety disorder (SAD) with regard to prevalence, comorbidity, and impairment.

Methods

This analysis was based on data from the German Health Survey (GHS) and its Mental Health Supplement (GHS-MHS). Social anxiety disorder and its syndromes as well as other mental disorders were assessed with a standardized diagnostic interview (M-CIDI) in 4,174 adults.

Results

The 12-month prevalence rate for threshold SAD was 2.0%, subthreshold and symptomatic social anxiety (one DSM-IV criterion missing/two or more criteria missing) was found in 3.0 and 7.5% of the participants, respectively. As expected, threshold SAD was characterized by an elevated risk for comorbid disorders and associated with impairment in diverse areas of life. However, this was also true for the two subthreshold expressions of social anxiety, which were also significantly associated with higher comorbidity and greater impairment compared to the control group.

Conclusions

Our results suggest that social anxiety below the diagnostic threshold is clearly associated with adverse outcomes. Prospective designs should examine the exact temporal and possible causal pathways of this burden in order to inform prevention and early intervention programs.

Key words

epidemiology prevalence social anxiety disorder social anxiety-impairment 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Lydia Fehm
    • 1
  • Katja Beesdo
    • 2
  • Frank Jacobi
    • 2
  • Agnes Fiedler
    • 2
  1. 1.Institute of PsychologyHumboldt-Unversität zu BerlinBerlinGermany
  2. 2.Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany

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