Social anxiety disorder (SAD) is the marked fear of performance or social situations. Patients with SAD have an excessive fear of scrutiny or evaluation, and of acting in a way (or showing anxiety symptoms) that may be humiliating. Studies indicate that the most common fears reported among patients with SAD (N=526) are public speaking, speaking to strangers, meeting new people, dealing with authority figures, and eating or writing in public (Slide 1).
According to the National Comorbidity Survey, SAD is the most prevalent of the anxiety disorders, with 12-month and lifetime rates of 7.4% and 13.3%, respectively (Slide 2). SAD usually manifests itself before age 20, is very common in adolescence, and is the most common anxiety disorder for which adolescents and teenagers drop out of high school or college.
More than 50% of patients with SAD suffer considerable functional impairment which can affect education, family relationships, marriage/romantic relationships, social network, and employment. One study reported that the wages of people with untreated SAD were ~10% lower than those of subjects without SAD, when adjusted for age and seniority. In addition, the probability of graduating college was ~10% less among those with SAD, and the probability of professional, managerial, or technical development in their careers was ~15% less. Of note, these subjects had only moderate social anxiety, and patients with severe social anxiety would likely suffer even more impairment.