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The DSM-IV criteria for the diagnosis of social phobia can be summarized as follows:
there is a marked and persistent fear of social or performance situations that involve exposure to unfamiliar people or to possible scrutiny, the patient's fears being that he or she will act in a way or show anxiety symptoms that will be embarrassing;
exposure to such situations produces anxiety, which may take the form of a panic attack; alternatively, the feared situation may be avoided;
the patient recognizes that the fear is excessive or unreasonable;
the disorder significantly affects the patient's normal routine;
the disorder is not due to the effects of a drug, to a general medical disorder or to another psychiatric disorder.
Generalized social phobia is diagnosed if the fears include most social situations.
In children, the duration of the disorder must be at least 6 months. Children may also not recognize that the fear is excessive or unreasonable.
The ICD-10 diagnostic criteria are similar but are more specific in that they list anxiety symptoms that must be present, and state that these symptoms must occur only or predominantly in relation to the feared situation.
Symptoms and signs
Specific situations almost always provoke an immediate anxiety response, which may take the form of a panic attack. Common anxiety symptoms include:
blushing;
gastrointestinal discomfort, nausea, diarrhea;
cold and clammy hands, sweating;
palpitations;
shaky voice, tremors, muscle tension;
confusion;
urgency to urinate.
Typical fears are of:
evaluation (either negative or positive) by others;
social interaction;
speaking, eating and drinking, or writing in public.
Patients with social phobia are often hypersensitive to criticism or rejection and have difficulty with assertiveness. The may have low self-esteem.
(from PsychiatryMatters.MD)
