Social anxiety disorder defined

DSM-IV defines social anxiety disorder as an excessive fear of scrutiny by others in social situations. Refer to Table 5.9 for the diagnostic criteria for social anxiety... 

The nosology of anxiety disorders has changed considerably over the past 40 years (141). Such disorders were not mentioned in the original DSM. In DSM-II, problems with anxiety were considered a subset of behavioral disorders and were restricted to overanxious and withdrawing reactions. The DSM-III defined three types of anxiety disorders in children and adolescents overanxious, avoidant, and separation disorder. The DSM-III also acknowledged that children and adolescents could meet adult criteria for simple phobias, panic disorder, posttraumatic stress disorder, and obsessive-compulsive disorder (OCD). In DSM-IV ( 45), generalized anxiety disorder (GAD) and social phobia (or social anxiety disorder with childhood onset) replaced overanxious disorder and avoidant disorder, respectively. 

Paroxetine is a selective serotonin reuptake inhibitor that blocks reuptake of serotonin, enhancing serotonergic function. It is used to treat panic disorder or social anxiety disorder (except Pexeva), as defined in the DSM-IV major depressive disorder, as defined in DSM-111 (immediate release) orDSM-lV (controlled release). Immediate release only for obsessive-compulsive disorder (OCD) generalized anxiety disorder (GAD) (except Pexeva) posttraumatic stress disorder (PTSD), as defined in the DSM-IV (except Pexeva). 

In this chapter, we consider categorical anxiety disorders as defined by the standardized diagnostic criteria of American Psychiatric Association s Diagnostic and Statistical Manual for Psychiatric Disorders [i.e., DSM-III (1980), DSM-III-R (1987), DSM-IV (1994)]. The subtypes of anxiety states included are panic disorder, agoraphobia, specific phobia, social phobia, generahzed anxiety/overanxious disorder, separation anxiety, and obsessive-compulsive disorder. 

A therapeutic range should be established for each patient. This range should define concentrations that result in minimal side effects and optimal seizure control. This therapeutic plasma concentration range should be used to identify the appropriate patient-specific dose. Patients should be monitored chronically for seizure control, comorbid conditions, social adjustment (including quality-of-life assessments), drug interactions, compliance, and adverse effects. Periodic screening for comorbid neuropsychiatric disorders such as depression and anxiety is also important. Clinical response is more important than the serum drug concentration. 

Although the etiology of autism is not understood, the defining or core symptoms of autistic disorder are considered to be impaired social interaction, impaired verbal and nonverbal communication, and restrictive, repetitive patterns of behavior. In addition, most patients with a primary diagnosis of autism exhibit other neurological or psychiatric symptoms, which may include seizures, sleep disorders, anxiety, panic attacks, attention deficit/hyperactivity, self-injury, and cognitive impairment (Simonoff et ah, 2008). It is not known to what extent these comorbidities reflect the primary pathology of autism and to what extent they represent unrelated vulnerabilities that are exacerbated by the impaired social interaction and communication that is characteristic of the disorder. 

---