Normal urinary free cortisol and postdexamethasone cortisol in social phobia: comparison to normal volunteers.

In primates, social stress is associated with activation of the hypothalamic-pituitary-adrenal (HPA) axis. Social phobia is a common, often disabling, form of pathological anxiety characterized by marked distress in situations involving possible scrutiny or evaluation. Little is known about HPA function in patients with social phobia.

An examination of syndromal validity and diagnostic subtypes in social phobia and panic disorder.

Background: We investigated whether patients with DSM-III-R panic disorder and patients with social phobia could be distinguished on the basis of selected demographic variables and by several commonly used anxiety and phobia rating scales.

Method: Sixty-six patients with social phobia and 60 patients with panic disorder (42 with and 18 without agoraphobia) were studied. Subjects completed a battery of self-report measures that assessed phobic fears, avoidance, and related problems.

Cognitive-behavioral and pharmacological treatments of social phobia. A controlled study.

Sixty-five patients with social phobia were treated in a study that compared a cognitive-behavioral group treatment program with pharmacotherapy with alprazolam, phenelzine sulfate, or pill-placebo plus instructions for self-directed exposure to phobic stimuli. Statistically significant repeated-measures effects were shown on all measures, indicating that the treatments studied were associated with substantial improvements in patients with severe and chronic social phobia. Patients who were treated with phenelzine were rated by clinicians as more improved on a measure of work and social disability than patients who were treated with alprazolam or placebo (patients in the cognitive-behavior therapy group were not rated on this measure).

Comorbidity for alcoholism and depression.

There has been a dramatic increase in attention to comorbidity between psychiatric disorders and substance abuse in both clinical and research settings. Patients with major psychiatric conditions and substance abuse often fall between the cracks in clinical settings because of administrative distinctions between substance abuse and mental health. This article reviews the evidence regarding an association between alcoholism and depression in clinical and epidemiologic studies.

The hypothalamic-pituitary-thyroid axis in social phobia.

The authors investigated indices of hypothalamic-pituitary-thyroid (HPT) axis function in patients with social phobia. They found no differences between patients with social phobia and age- and sex-matched control subjects in plasma T3, T4, free T4, or TSH levels or in the proportion of subjects with positive antithyroid antibodies. Patients with social phobia and control subjects also did not differ in three of the four measures used to assess TSH response to TRH.