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Anxiety Disorders

Social Anxiety Disorder

ICD-10-CM: F40.10

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1. Criteria

DSM Criteria

Criterion A

  • Marked fear or anxiety occurs in one or more social situations involving possible scrutiny by others.
  • The person fears acting in a way or showing anxiety symptoms that will be negatively evaluated.

DSM Criteria

Criterion B

  • The social situations almost always provoke fear or anxiety.

DSM Criteria

Criterion C

  • The social situations are avoided or endured with intense fear or anxiety.

DSM Criteria

Criterion D

  • The fear or anxiety is out of proportion to the actual threat posed by the social situation and the sociocultural context.

DSM Criteria

Criterion E

  • The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more.

DSM Criteria

Criterion F

  • The fear, anxiety, or avoidance causes clinically significant distress or impairment.

DSM Criteria

Criterion G

  • The symptoms are not attributable to a substance or another medical condition.

DSM Criteria

Criterion H

  • The disturbance is not better explained by another mental disorder.

DSM Criteria

Criterion I

  • If another medical condition is present, the fear is clearly unrelated or excessive.

2. Context

  • Social anxiety disorder is usually about being seen, judged, embarrassed, or exposed in front of other people. Some patients avoid those situations entirely, while others keep showing up but feel tense, preoccupied, and exhausted by the experience.
  • Scrutiny theme: The feared outcome is usually some form of negative evaluation, like embarrassment, rejection, humiliation, or visibly looking anxious.
  • Duration: This tends to be a stable pattern, not just a bad week or a rough stretch before one important event.
  • Subtype thinking: Some people fear only performance situations, while others struggle across much broader social and interpersonal settings.
  • Clinical focus: Common clinician-rated or self-report scale for social fear and avoidance.

3. Validated scales

Liebowitz Social Anxiety Scale

Common clinician-rated or self-report scale for social fear and avoidance.

SPIN

Brief self-report screen and severity tracker.

4. FDA approved treatments

FDA-indicated medications commonly used for social anxiety disorder

FDA labeling for social anxiety disorder exists for selected SSRIs and SNRIs; verify the specific product label before clinical use.

Interventional psychiatry modalities

  • TMS is under study in social anxiety disorder.
  • Ketamine is investigational for refractory anxiety symptoms.
  • ECT is not standard for isolated social anxiety disorder.
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5. Top management articles

  1. Social anxiety disorder The Lancet review
  2. Cognitive behavioral therapy for social anxiety disorder Treatment literature
  3. Pharmacotherapy for social anxiety disorder Review literature