Background. General population data were used to study co-morbidities between lifetime social
phobia and mood disorders.
Methods. Data come from the US National Comorbidity Survey (NCS).
Results. Strong associations exist between lifetime social phobia and major depressive disorder
(odds ratio 2·9), dysthymia (2·7) and bipolar disorder (5·9). Odds ratios increase in magnitude with
number of social fears. Reported age of onset is earlier for social phobia than mood disorders in
the vast majority of co-morbid cases. Temporally-primary social phobia predicts subsequent onset
of mood disorders, with population attributable risk proportions of 10–15%. Social phobia is also
associated with severity and persistence of co-morbid mood disorders.
Conclusions. Social phobia is a commonly occurring, chronic and seriously impairing disorder that
is seldom treated unless it occurs in conjunction with another co-morbid condition. The adverse
consequences of social phobia include increased risk of onset, severity and course of subsequent
mood disorders. Early outreach and treatment of primary social phobia might not only reduce the
prevalence of this disorder itself, but also the subsequent onset of mood disorders.