2013 NICE 159 临床指南:社交焦虑障碍的诊治临床指南
NICE clinical guideline 159 :Social anxiety disorder: recognition, assessment and treatment
2013-05-22
This guidance updates and replaces the section of NICE technology appraisal guidance 97(published February 2006) that deals with phobia.Social anxiety disorder (previously known as 'social phobia') is one of the most common of theanxiety disorders. Estimates of lifetime prevalence vary but according to a US study, 12% ofadults in the US will have social anxiety disorder at some point in their lives, compared withestimates of around 6% for generalised anxiety disorder (GAD), 5% for panic disorder, 7% forpost-traumatic stress disorder (PTSD) and 2% for obsessive–compulsive disorder. There is asignificant degree of comorbidity between social anxiety disorder and other mental healthproblems, most notably depression (19%), substance-use disorder (17%), GAD (5%), panicdisorder (6%), and PTSD (3%).Social anxiety disorder is persistent fear of or anxiety about one or more social or performancesituations that is out of proportion to the actual threat posed by the situation. Typical situationsthat might be anxiety-provoking include meeting people, including strangers, talking in meetingsor in groups, starting conversations, talking to authority figures, working, eating or drinking whilebeing observed, going to school, going shopping, being seen in public, using public toilets andpublic performances such as public speaking. Although worries about some of these situationsare common in the general population, people with social anxiety disorder worry excessivelyabout them at the time and before and afterwards. They fear that they will do or say somethingthat they think will be humiliating or embarrassing (such as blushing, sweating, appearing boringor stupid, shaking, appearing incompetent, looking anxious). Social anxiety disorder can have agreat impact on a person's functioning, disrupting normal life, interfering with social relationshipsand quality of life and impairing performance at work or school. People with the disorder maymisuse alcohol or drugs to try to reduce their anxiety (and alleviate depression).Children may show their anxiety in different ways from adults: as well as shrinking frominteractions, they may be more likely to cry, freeze or have tantrums. They may also be lesslikely to acknowledge that their fears are irrational when they are away from a social situation.Particular situations that can cause difficulty for socially anxious children and young peopleinclude participating in classroom activities, asking for help in class, joining activities with peers(such as attending parties or clubs), and being involved in school performances.
