Pélissolo A, Lépine J P
INSERM U302, Hôpital de la Salpêtrière, Paris.
Encephale. 1995 Jan-Feb;21(1):15-24.
Social phobia is individualized in international classifications only since 1980 with the DSM III, ten years after the publication by Marks of its phobic disorders classification. Nevertheless, many european authors, psychiatrists or psychologists, have raised the question of social anxiety as far back as the eighteenth century, with various points of view and appellations. The first report of an ereutophobia observation is due to Casper, in 1846, which described a serious social anxiety affecting a young man. Ereutophobia has been especially studied by Pitres and Regis, in 1807 and 1902, and by Claparede in a comprehensive review published in the same period. Janet has also proposed, in 1903, a classification of phobia including a section for social phobia. In 1910, Hartenberg has described several forms of social anxiety under the generic term of shyness (timidity, performance anxiety, personality disorders, etc.). Then, there is a relative silent period until 1960 even if the names of Kontaktneurosen or social neurosis are punctually mentioned in british and german literatures, and if Morita, in Japan, has taken an interest in social anxiety around 1930. The existence of social phobia as a valid syndrome A has been confirmed in the successive classifications since the DSM III. Several structured interview schedules or self-rating scales have been proposed for assessment of social phobia, such as Liebowitz or Davidson scales, but at present no one instrument has demonstrated superiority and the use of a battery of several scales is recommended. Moreover, some diagnostic issues are not yet completely solved, in particular concerning the validity of different subtypes of social phobia. To date, only the generalized type has been individualized in the classifications when circumscribed and performance types remain disputed. Delineation of social phobia with avoidant personality, shyness, performance and test anxiety, other phobic disorders and complications like alcoholism are discussed. Clinical, epidemiological and therapeutical implications of these questions are of importance from a theoretical but also practical point of view.
社交恐惧症在国际分类中直到1980年《精神疾病诊断与统计手册》第三版才开始单独列出，这是在马克斯发表其恐惧症分类十年之后。然而，早在18世纪，许多欧洲作者，包括精神病学家或心理学家，就从不同的观点和称谓出发，提出了社交焦虑的问题。1846年，卡斯珀首次报告了对脸红恐惧症的观察，描述了一名年轻人遭受的严重社交焦虑。1807年和1902年，皮特雷和雷吉对脸红恐惧症进行了专门研究，克拉帕雷德在同一时期发表的一篇综合评论中也进行了研究。1903年，雅内还提出了一种恐惧症分类，其中包括社交恐惧症部分。1910年，哈滕贝格用羞怯这一通用术语描述了几种社交焦虑形式（胆小、表演焦虑、人格障碍等）。然后，直到1960年都有一段相对沉寂的时期，尽管在英国和德国文献中偶尔会提到接触性神经症或社交神经症的名称，并且在20世纪30年代左右日本的森田也对社交焦虑产生了兴趣。自《精神疾病诊断与统计手册》第三版以来，社交恐惧症作为一种有效的综合征A在后续分类中得到了确认。已经提出了几种结构化访谈量表或自评量表来评估社交恐惧症，如利博维茨量表或戴维森量表，但目前没有一种工具显示出优越性，建议使用一系列多个量表。此外，一些诊断问题尚未完全解决，特别是关于社交恐惧症不同亚型的有效性。迄今为止，在分类中只有广泛性社交恐惧症得到了单独列出，而局限型和表演型仍存在争议。本文讨论了社交恐惧症与回避型人格、羞怯、表演和考试焦虑、其他恐惧症以及诸如酗酒等并发症的区分。从理论和实践的角度来看，这些问题的临床、流行病学和治疗意义都很重要。
