EPA-0914 – Social anxiety disorder and psycosis: A relation not always met

Abstract

Objective When social anxiety and psychotic disorders occur in the same patient, they have mutual implications in both disease courses. Social anxiety disorder is mainly characterized by the fear of embarrassment in social or performance situations, accompanied by the intense concern about other people's opinion. Psychotic disorders are traditionally seen as being accompanied by affective blunting and deterioration of social skills. The authors pretend to review different interactions between these disorders, by exploring several clinical scenarios where both disorders influence themselves in different ways. Methods The authors review reports and literature in the files of Pumed, Medline and others. They also consult psychiatry textbooks. Results Many psychotic patients have other affective disturbances than that of affective blunting. Social anxiety is one of them; some studies point a prevalence of 25% in these patients. But if in some patients social anxiety seems to act as a trigger of psychotic symptoms, acting as a persistent stressor, other patients have anxiety in interacting with others as a consequence of having a psychotic disorder and the fear of being noted as having a serious mental disorder affecting ones behaviour. In a third scenario, social anxiety occurs as a product of a primary thought disorder (psychotic self-reference). It is possible to identify therapeutic implications of these comorbidity, namely by the use of cognitive behaviour therapy. Conclusion Comorbidity between psychosis and social anxiety can occur in different ways, influencing the prognosis of both disorders. It also can challenge the knowledge about these disorders.