Is ?shy bladder syndrome? a subtype of social anxiety disorder? A survey of people with paruresis

Abstract

Paruresis is characterized by the fear of not being able to urinate in public bathrooms and has been classified by some to be a sub-type of social anxiety disorder (social phobia). Despite the existence of a consumer advocacy organization, the "Intentional Paruresis Association (www.paruresis.org)," there is sparse literature on this condition. A survey of people affiliated with the "International Paruresis Association" was undertaken using a self-report questionnaire with items that addressed demographic variables, the phenomenology of paruresis, comorbid disorders, and the impact of symptoms on quality of life. Sixty-three patients (59 M, 4 F) completed the questionnaire. The mean age of the subjects was 38.1+/-12 years, with the mean duration of symptoms being 24.5+/-13 years. Paruresis impacts significantly on sufferers' lives, with approximately one third limiting or avoiding parties, sports events, or dating and just over half of the sample limiting the job they choose to do. Social anxiety disorder (SAD) and depression are the most common comorbid disorders and the most common disorders in family members. Analysis of Liebowitz Social Anxiety Scale (LSAS) scores showed higher performance than social interaction subscale scores across the whole sample (whether suffering from SAD or not.) However, compared to subjects without co-morbid SAD, those with comorbidity had higher total, performance, and social interaction scores. Thus, paruresis can be a chronic and disabling symptom, and there seems to be an association between paruresis and other performance anxieties. Further research to characterize paruresis and to determine effective treatments is needed.