The Epidemiology of Social Anxiety Disorder in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Objective: To present nationally representative data on 12-month and lifetime prevalence, correlates and comorbidity of social anxiety disorder (SAD) among adults in the United States as determined by the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions.

Design: Face-to-face survey.

Setting: The United States.

Participants: Adults (aged 18 and over) residing in households and group quarters (N = 43,093).

Main Outcome Measures: Prevalence and associations of SAD with sociodemographic and psychiatric correlates and Axis I and II disorders.

Results: The prevalence of 12-month and lifetime DSM-IV SAD was 2.8% (95% CI = 2.5 to 3.1) and 5.0% (95% CI = 4.6 to 5.4), respectively. Being Native American, being young, or having low income increased risk, while being male, being of Asian, Hispanic, or black race/ethnicity, or living in urban or more populated regions reduced risk. Mean age at onset of SAD was 15.1 years, with a mean duration of 16.3 years. Over 80% of individuals with SAD received no treatment, and the mean age at first treatment was 27.2 years. Current and lifetime SAD were significantly related to other specific psychiatric disorders, most notably generalized anxiety, bipolar I, and avoidant and dependent personality disorders. The mean number of feared social situations among individuals with SAD was 7.0, with the majority reporting anxiety in performance situations.

Conclusions: Social anxiety disorder was associatedwith substantial unremitting course and extremelyearly age at onset. Social anxiety disorderoften goes untreated, underscoring the need forhealth care initiatives geared toward increasingrecognition and treatment. Comprehensive evaluationof patients with SAD should include a systematicassessment of comorbid disorders, and novelapproaches to the treatment of comorbid SAD areneeded.’ ‹’ ‹