Patients meeting DSM-III-R criteria for social phobia are evaluated using psychological, physiological, biochemical and pharmacotherapeutic methodologies. The SAAD investigates the phenomenology, neuroendocrinology, and treatment of social phobia. Current evidence indicates that social phobia can be distinguished from panic disorder on a number of previously validated rating scales. A discriminate function analysis has yielded an algorithm which can correctly diagnose subjects 80% of the time. These syndromes differ in life-time rates of major depression as well as age of onset and sex-distribution. Preliminary evidence suggests that social phobia may be associated with minor disturbances in noradrenergic and/or autonomic dysfunction, although the clinical significance, if any, of these findings have yet to be determined. The Section found that social phobic patients respond to treatment with phenelzine and alprazolam, although phenelzine is significantly superior to alprazolam on a global measure of work and social function. Preliminary evidence suggests that fluoxetine is effective in the treatment of social phobia. A pilot study has been initiated to test the relative efficacy of imipramine versus phenelzine in the treatment of social phobia.
