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There is a high degree of comorbidity with other psychiatric disorders. Social phobia often occurs alongside low self-esteem and clinical depression, due to lack of personal relationships and long periods of isolation from avoiding social situations. To try to reduce their anxiety and alleviate depression, people with social phobia may use alcohol or other drugs, which can lead to substance abuse. It is estimated that one-fifth of patients with social anxiety disorder also suffer from alcohol dependence.[1] The most common complementary psychiatric condition is unipolar depression. In a sample of 14,263 people, of the 2.4 percent of persons diagnosed with social phobia, 16.6 percent also met the criteria for clinical depression.[2] Besides depression, the most common disorders diagnosed in patients with social phobia are panic disorder (33 percent), generalized anxiety disorder (19 percent), post-traumatic stress disorder (36 percent), substance abuse disorder (18 percent), and attempted suicide (23 percent).[3] In one study of social anxiety disorder among patients who developed comorbid alcoholism, panic disorder, or depression, social anxiety disorder preceded the onset of alcoholism, panic disorder and depression in 75 percent, 61 percent, and 90 percent of patients, respectively. Avoidant personality disorder is also highly correlated with social phobia.[4] Because of its close relationship and overlapping symptoms with other illnesses, treating social phobics may help understand underlying connection in other psychiatric disorders.

There is research indicating that social anxiety disorder is often correlated with bipolar disorder[5]. Some researchers believe they share an underlying cyclothymic-anxious-sensitive disposition.[6] In addition, studies show that more socially phobic patients treated with anti-depressant medication develop hypomania than non-phobic controls[1][7]. This can be seen as the medication creating a new problem, and also has this adverse effect in a proportion of those without social phobia.


  1. Alcohol Research and Health. Sarah W. Book, Carrie L. Randall. Social anxiety disorder and alcohol use. Retrieved February 24, 2006.
  2. Crozier, page 358-9.
  3. eNotes. Social phobia Retrieved February 23, 2006.
  4. Crozier, page 361.
  5. Pini S, Maser JD, Dell'Osso L, et al (2006). Social anxiety disorder comorbidity in patients with bipolar disorder: a clinical replication. J Anxiety Disord 20 (8): 1148–57.
  6. Perugi G, Akiskal HS (Dec 2002). The soft bipolar spectrum redefined: focus on the cyclothymic, anxious-sensitive, impulse-dyscontrol, and binge-eating connection in bipolar II and related conditions. Psychiatr. Clin. North Am. 25 (4): 713–37.
  7. Valença AM, Nardi AE, Nascimento I, et al (May 2005). Do social anxiety disorder patients belong to a bipolar spectrum subgroup?. J Affect Disord 86 (1): 11–8.

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