Comorbidity and social phobia: clinical and epidemiological issues.

Both epidemiological and clinical studies indicate that social phobia is highly comorbid with anxiety and affective disorders and, to a lesser extent, with substance use disorders. In epidemiological surveys, about one in five subjects with social phobia has been reported as having no other lifetime disorder. Other patterns of comorbidity with eating disorders, personality disorders and medical morbidity have been studied more recently and are reviewed here. Comorbidity has a strong influence on impairment, health-seeking behavior and suicidality. These results have major implications for improving the recognition, assessment and treatment of this disorder by physicians and for the design of new research perspectives.