Liebowitz Social Anxiety Scale Scores Research Articles

Positive effects of employee psychological assistance programs on HR patients with social anxiety disorder

BackgroundWith the continuous improvement of employees’ humanized needs, more and more enterprises have set up employee psychological assistance programs. The way of diagnosing and advising organizations and employees through professionals, providing professional guidance, training and counseling is also of certain research value for the treatment of HR patients with social anxiety disorder.Subjects and MethodsThe study selected 38 people with SAD and 22 healthy controls to complete the Liebowitz Social Anxiety Scale. At the same time, eye tracking technology was used to investigate the eye movement attention of the two groups of subjects to their own faces with different emotions, and the changes in symptoms and eye movement characteristics of SAD patients were followed up for 4 weeks.ResultsThe healthy group scored 9.950±4.87, and before the EPA intervention, SADHR patients had a higher score on the Liebowitz Social Anxiety Scale of 77.610±24.00. After the EPA intervention, the Liebowitz Social Anxiety Scale score of SADHR patients was significantly reduced by 52.6% compared with the previous one. The results of eye tracking studies changed, with a significant increase in the order of first fixation points in the 4-week region of interest.ConclusionsPatients with SADHR have a high level of self-attention, and most of them are negative and have low self-evaluation. After using the EPA intervention, the self-evaluation of SADHR patients improved. Social anxiety symptoms were not significantly correlated with eye movement features of one’s own face.

Incongruent gestures slow the processing of facial expressions in university students with social anxiety.

In recent years, an increasing number of studies have examined the mechanisms underlying nonverbal emotional information processing in people with high social anxiety (HSA). However, most of these studies have focused on the processing of facial expressions, and there has been scarce research on gesture or even face-gesture combined processing in HSA individuals. The present study explored the processing characteristics and mechanism of the interaction between gestures and facial expressions in people with HSA and low social anxiety (LSA). The present study recruited university students as participants and used the Liebowitz Social Anxiety Scale scores to distinguish the HSA and LSA groups. We used a 2 (group: HSA and LSA) × 2 (emotion valence: positive, negative) × 2 (task: face, gesture) multifactor mixed design, and videos of a single face or gesture and combined face-gesture cues were used as stimuli. We found that (1) there is a distinction in the processing of faces and gestures, with individuals recognizing gestures faster than faces; (2) there is an attentional enhancement in the processing of gestures, particularly for negative gestures; and (3) when the emotional valence of faces and gestures align, it facilitates the recognition of both. However, incongruent gestures have a stronger impact on the processing of facial expressions compared to facial expressions themselves, suggesting that the processing of facial emotions is more influenced by environmental cues provided by gestures. These findings indicated that gestures played an important role in emotional processing, and facial emotional processing was more dependent on the environmental cues derived from gestures, which helps to clarify the reasons for biases in the interpretation of emotional information in people with HSA.

Baseline Severity as a Moderator of the Waiting List–Controlled Association of Cognitive Behavioral Therapy With Symptom Change in Social Anxiety Disorder

Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P < .001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P = .009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.

Functional Connectivity Between Basal Forebrain and Superficial Amygdala Negatively Correlates with Social Fearfulness

Social anxiety is characterized by an intense fear of evaluation from others and/or withdrawal from social situations. Extreme social anxiety can lead to social anxiety disorder. There remains an urgent need to investigate the neural substrates of subclinical social anxiety for early diagnosis and intervention to reduce the risk to develop social anxiety disorder. Twenty-nine young adults were recruited (10 males/19 females; mean age (SD) = 20.34 (2.29)). Trait-like social anxiety was assessed by Liebowitz Social Anxiety Scale. Functional magnetic resonance imaging was used with an emotional face-matching paradigm to probe brain activation in response to emotional stimuli including angry, fearful, and happy faces, with shape-matching as a control condition. Behavioral results showed positive correlations between Liebowitz Social Anxiety Scale scores and the reaction time in both angry and fearful conditions. The activation of superficial amygdala and the deactivation of basal forebrain in response to angry condition showed positive correlations with the level of social anxiety. In addition, the resting-state functional connectivity between these two regions was negatively correlated with the level of social anxiety. These results may help to understand the individual difference and corresponding neural underpinnings of social anxiety in the subclinical population, and might provide some insight to develop strategies for early diagnosis and interventions of social anxiety to reduce the risk of deterioration from subclinical to clinical level of social anxiety.

Antidepressants for social anxiety disorder: A systematic review and meta-analysis.

This systematic review is aimed to update and reintegrate the pharmacotherapy of social anxiety disorder (SAD), including the Japanese medical database. We conducted a systematic review and meta-analysis of pharmacotherapy of SAD according to the Medical Information Distribution Service. We used data from a most recent systematic review, and updated search were conducted using MEDLINE, PubMed, CENTRAL, ICTRP, and ICHUSHI from August 1st, 2017 to January 31st, 2022. The outcome were response rates assessed by Clinical Global Impressions Improvement, efficacy assessed by the Liebowitz Social Anxiety Scale (LSAS), and dropout rates. We performed a random effect of meta-analysis to obtain the differences in each outcome between active medication and placebo. We used RevMan version 5.3 for analyses. We identified 5 studies through update search and performed meta-analysis for 33 studies on selective serotonin reuptake inhibitor (SSRI) and 6 studies on serotonin noradrenalin reuptake inhibitor (SNRI). The response rate (RR=1.62) and the LSAS score reduction (mean difference=-9.65) of SSRI, and the response rate (RR=1.57) and the LSAS score reduction (mean difference=-11.72) of SNRI were significantly different from placebo. The dropout rates of SSRI or SNRI were not significant. The response rates of SSRIs in both Japanese studies (RR=1.44) and countries other than Japan (RR=1.67) were significant. Most findings were based on low quality of evidence. SSRIs are valid option for pharmacotherapy of SAD including Japanese patients. SNRIs are another effective option. However, the results should be interpreted cautiously due to several risk of bias.

Improvement in social anxiety following a return-to-work intervention for patients with depression.

Purpose:To retrospectively examine depression and social anxiety improvement in patients on sick leave due to depression who participated in a return-to-work intervention (RTW-I) program.Methods:Patients visited a psychiatric outpatient clinic simulating workplaces to learn recurrence prevention skills through RTW-Is, including group cognitive behavioral therapy, from April 1, 2013, to September 30, 2017. The Beck Depression Inventory-Second Edition (BDI-II), Social Adaptation Self-Evaluation Scale (SASS), and Liebowitz Social Anxiety Scale (LSAS) scores of 112 patients were analyzed before and after the intervention program. Missing postprogram data were substituted using the last observation carried forward scores. Next, 45 patients who responded to the work continuity survey 1 year after RTW-I were categorized into Group A (patients who continued working: 37) and Group B (those who did not continue: 8).Results:The mean BDI-II scores significantly decreased from preintervention 19.4 to postintervention 7.9 (t = 13.303, P < .001). The mean SASS scores significantly increased from preintervention 31.9 to postintervention 36.0 (t = −5.953, P < .001). The mean LSAS scores significantly decreased from preintervention 54.7 to postintervention 37.0 (t = 8.682, P < .001), and all scores demonstrated an improvement. Patients who continued working showed improved depressive and social anxiety symptoms. The BDI-II and SASS scores showed no significant differences between the groups, but the postintervention LSAS scores were significantly different (P = .041). LSAS score changes: Group A = −26.2; Group B = −9.8; estimated difference: −17.920, 95% CI: −32.181 to −3.659, P = .015.Conclusions:The RTW-I program improved depressive and social anxiety symptoms. Patients with improved scores continued working for 1 year after the intervention.Trial registration: This trial was retrospectively registered with the UMIN Clinical Trial Registry (UMIN-CTR) (ID: UMIN000037662) on August 10, 2019.

Descended Social Anxiety Disorder and Craving in Women Heroin Dependence Through Exercise Alerts Plasma Oxytocin Levels.

Purpose: This study explored the association between peripheral blood oxytocin (OT) and social anxiety disorder (SAD) and cue-induced cravings in female heroin addicts. The effect of exercise on alleviation of SAD and OT levels was also explored.Methods: A total of 72 females with heroin dependence were assigned to three groups based on SAD severity. The three groups were Non-SAD control, SAD control, and SAD exercise groups. Subjects in the SAD exercise group underwent aerobic exercise and resistance training for 8 weeks (60 min/day, 5 days/week). Enzyme-linked immunosorbent assay analysis and Liebowitz Social Anxiety Scale (LSAS) scores were used to determine plasma OT concentration and SAD, respectively. Cue-induced craving was assessed using Visual Analog Scale (VAS) and Desires for Drug Questionnaire (DDQ). Mixed-effect analysis of variance and Pearson correlation analysis were used to explore the effect and correlation between different parameters.Results: OT levels in the SAD exercise group were significantly high after exercise (p < 0.01). LSAS, VAS, and DDQ (“Desire and Intention” and “Negative reinforcement”) scores in the SAD exercise group were significantly lower after exercise (p < 0.01). Plasma OT level was negatively correlated with LSAS score (r = −0.534, p < 0.001), VAS score (r = −0.609, p < 0.001), “Desire and Intention” score (r = −0.555, p < 0.001), and “Negative reinforcement” score (r = −0.332, p < 0.01) and positively correlated with the “control” score (r = 0.258, p < 0.05). LSAS was positively correlated with VAS score (r = 0.588, p < 0.001) and “Desire and Intention” score (r = 0.282, p < 0.05).Conclusions: The findings of the present study indicate that plasma OT is a potential peripheral biomarker for prediction of the severity of social anxiety in female heroin withdrawal patients. Aerobic exercise combined with resistance training plus incremental load for 8 weeks can increase plasma OT levels and significantly reduce severity of SAD and cue-induced cravings in female heroin addicts.

Assessment of anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress in psoriasis patients: a controlled cross-sectional study

Objective: Psoriasis is a chronic inflammatory skin disease, and psychiatric comorbidities are common in these patients. Skin lesions can cause shame, anxiety, social avoidance, irritability, and depressive symptoms in psoriasis patients. This study aimed to investigate anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress in patients with psoriasis and their relationship with disease severity and duration. Methods: Forty patients and 40 healthy controls were included in our study. All study patients were administered the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), the Liebowitz Social Anxiety Scale (LSAS), the Perceived Stress Scale (PSS-14), and the Anxiety Sensitivity Index (ASI-3). Disease severity in psoriasis patients was assessed using the Psoriasis Area Severity Index (PASI). Results: Anxiety, depression, social anxiety, perceived stress, and anxiety sensitivity were significantly higher in psoriasis patients than in healthy controls. There was no correlation between PASI scores and BAI, BDI, LSAS, PASS-14 and ASI-3 scores. Also, no correlation was found between disease duration and BAI, BDI, LSAS, PSS-14 and ASI-3 scores. Conclusion: Our results show that anxiety, depression, social anxiety, anxiety sensitivity, and perceived stress are high in psoriasis patients regardless of disease duration and severity. This is the first study to examine anxiety sensitivity in psoriasis patients to the best of our knowledge. Clinicians should consider the possible psychiatric comorbidity at all stages of the disease in patients with psoriasis. Collaboration between the disciplines of dermatology and psychiatry is necessary to ensure full recovery and maintain patient well-being.

Social phobia and its relationship with perceived epilepsy-associated stigma in patients with epilepsy

Patients with epilepsy (PWE) might feel stigmatized due to the likelihood of having uncontrollable seizures and the possibility of their sudden occurrence in the community, which may lead to increased rates of social phobia in these patients. People with social phobia interpret others' attitudes toward them negatively and hence feel stigmatized. This vicious circle may be applied to PWE, reduces the quality of life and might cause them more challenging psychosocial problems than seizure management. We aimed to investigate the relationship between social phobia and stigmatization in PWE. Forty PWE and 40 age- and sex-matched healthy control subjects (HC) were included in the study. Liebowitz social anxiety scale (LSAS), Beck anxiety inventory (BAI), and Beck depression inventory (BDI)-II were administered to all participants. In addition to these, the stigma scale of epilepsy (SSE) was applied to the PWE, and the subcategory scores of this scale were calculated. The mean ages of the patient group and HC were determined to be 32.68 ± 10.67 and 33.80 ± 7.81, respectively (p>0.05). A significant difference was determined in the BDI-II, LSAS, and BAI scores of the patient group compared to HC (p<0.05). A significant correlation was found between scores of LSAS and SSE and this relationship continued regardless of depression levels (p<0.05). Our results demonstrate that social phobia is positively correlated with stigmatization in PWE. In PWE, psychiatric disorders are generally under-recognized and mistreated. Plus, it has a substantial impact on patients' quality of life. To achieve the social reintegration of these patients, comorbid psychiatric conditions of the disease and the factors associated with these conditions should be identified and treated.

False Safety Behavior Elimination Therapy for Social Anxiety Disorder in Japanese: A Pilot, Single‐Arm Uncontrolled Study1

AbstractSocial anxiety disorder (SAD) is characterized by an excessive fear of social situations that can lead to serious functional impairment; it negatively affects a person’s self‐esteem and social interactions. Its prevalence has increased over the past four decades, and SAD is one of the most prevalent psychiatric disorders in Japan. Therefore, more precise interventions are needed. This study administered false safety behavior elimination therapy (F‐SET), which eliminates safety behavior (i.e., strategies that reduce anxiety), to six Japanese patients with SAD. This is the first adaptation of F‐SET into Japanese. Seven patients were screened and six (Mage = 27.83 years, only males) were eligible for the study criteria. Each patient received five weekly 60‐min F‐SET sessions. At post‐F‐SET, the mean reduction in Liebowitz Social Anxiety Scale score from baseline was −20.50 (95% confidence interval: −30.65, −10.35; p = .003). After completing the treatment, all participants showed substantially decreased SAD symptoms, which indicates preliminary support for the adapted treatment’s efficacy.

Role of Body Dysmorphic Disorder in Patients With Postparalytic Facial Synkinesis.

To evaluate the role of body dysmorphic disorder (BDD) in patients with postparalytic facial nerve syndrome with synkinesis (PFS). A single-center retrospective cohort study. A total of 221 adults (74% women; median age: 44 years; median duration since onset of facial palsy: 1.6 years) were included. To diagnose BDD, the BDD Munich Module was used. Associations with House-Brackmann grading, Stennert index grading, Facial Clinimetric Evaluation (FaCE) survey, Facial Disability Index (FDI), general quality of life (SF-36), Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) was analyzed. A total of 59 patients (27%) were classified as patients with BDD. Significant associations were found between the diagnosis of BDD and female gender and lower FDI, FaCE, and SF-36 scores and higher BDI and LSAS scores. Multivariate analysis revealed BDI, FaCE total score, and FaCE social function subscore as independent factors associated with BDD. BDD was a relevant diagnosis in patients with PFS. A higher BDD level was associated with general and facial-specific quality of life and more psychosocial disabilities. Optimal treatment of PFS has to include these nonmotor dysfunctions. 3 Laryngoscope, 131:E2518-E2524, 2021.

Emotional Information Processing and Assessment of Cognitive Functions in Social Anxiety Disorder: An Event-Related Potential Study.

The aim of our study was to determine deficits in cognitive areas, including social cognition such as emotion recognition capacity, theory of mind, and electrophysiological alterations in patients with social anxiety disorder (SAD) and to identify their effects on clinical severity of SAD. Enrolled in our study were 26 patients diagnosed with SAD and 26 healthy volunteers. They were administered the Liebowitz Social Anxiety Scale (LSAS), Reading Mind in the Eyes Test (RMET), and Cambridge Neuropsychological Test Automated Battery. EEG monitoring was performed for electrophsiologic investigation. In the patient group, total reading the mind scores were lower (P = .027) while P300 latencies and emotion recognition latency during the Emotion Recognition Task (ERT) were longer (P = .038 and P = .012, respectively). The false alarm scores in the Rapid Visual Information Processing Task (RVP) were higher in the patient group (P = .038). In a model created using multivariate linear regression analysis, an effect of ERT and RVP scores on LSAS scores was found. Results of our study confirm that particularly impairment of cognitive functions such as sustained attention and emotion recognition may seriously affect the clinical presentation negatively. P300 latency in the parietal region may has the potential to be a biological marker that can be used in monitoring treatment.

Differential effects of adult attachment in cognitive‐behavioural and psychodynamic therapy in social anxiety disorder: A comparison between a self‐rating and an observer rating

Different measures of attachment are usually weakly correlated. In a subsample of an RCT comparing short-term cognitive-behavioural therapy (CBT) and psychodynamic therapy (PDT), we examined the association between attachment and outcome using two attachment measures. The sample comprises 148 patients with social anxiety disorder who were treated in the SOPHO-NET trial. Pretreatment attachment was assessed using the Adult Attachment Prototype Rating (AAPR) and the Bielefeld Questionnaire of Client Expectations (BQCE). Regression models were used to predict the therapeutic alliance (HAQ) at session 8, the Liebowitz Social Anxiety Scale (LSAS) at the end of therapy and a 6-month follow-up. Attachment groups (secure, avoidant, and ambivalent) classified with the AAPR and the BQCE were not significantly correlated (Cohen's κ = 0.08). Only the BQCE was associated with the HAQ indicating avoidantly attached patients showing lower HAQ scores than securely attached (Cohen's d = 0.722). Regarding the AAPR, we found an interaction effect of treatment and attachment related to the post-treatment LSAS scores. Post hoc tests revealed that securely attached patients in CBT had lower scores than securely attached in PDT (d = 0.922) and, on a trend level, avoidantly attached in CBT (d = 0.782). We conclude that attachment-outcome associations are affected by the applied measure. The identified differential effects suggest that psychotherapists should adapt the interventions on the attachment of their patients.

The Relationship Between Social Anxiety Disorder and Motor Symptoms of Parkinson Disease: A Pilot Study

BackgroundIn patients with Parkinson disease (PD), motor symptoms coexist with several nonmotor neuropsychiatric symptoms. Various anxiety subtypes (generalized anxiety disorder, panic disorder, and social anxiety disorder [SAD]) are more prevalent in patients with PD than in the general population. ObjectiveWe estimated the prevalence of SAD in early patients with PD and the relationship between severity of SAD and PD symptoms. MethodsThe Liebowitz Social Anxiety Scale (LSAS) and Unified Parkinson's Disease Rating Scale (UPDRS) III, which assess function impairment, were used to grade symptom severity among 41 patients with early PD. Ratings were compared and analyzed in relation to UPDRS subdivisions. ResultsUPDRS III and LSAS scores were not significantly correlated (r = 0.23, P = 0.14), but LSAS and UPDRS I, which evaluate nonanxiety psychiatric symptoms, were significantly correlated (r = 0.44; P = 0.004) and were stronger in the group not treated for PD (r = 0.82) but were in the group treated for PD (r = 0.28), although this difference did not reach statistical significance (P = 0.07 using the Fisher r-to-z transformation). LSAS also correlated with total UPDRS and UPDRS II (P ≤ 0.04). ConclusionsResults suggest that SAD symptoms in patients with PD correlate with PD symptoms as evaluated by the total UPDRS and UPDRS I and II. In our pilot study, this correlation was higher in levodopa-untreated patients with PD but was not statistically significant. Because the UPDRS III and LSAS were not statistically significantly correlated, a direct motor correlation with SAD symptoms cannot be suggested. Further investigation is needed to clarify the relationship of SAD in patients with PD and potential treatment options.

Efficacy and tolerability of paroxetine in adults with social anxiety disorder: A meta-analysis of randomized controlled trials.

The present study aimed to estimate the comprehensive efficacy and tolerability of paroxetine in adult patients with social anxiety disorder (SAD). We conducted a comprehensive literature review of the PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials databases for eligible randomized controlled trials (RCTs). The efficacy outcome was the mean change of different kinds of scale scores as well as response and remission rates. The secondary outcome was tolerability, defined as the discontinuation rate and the incidence of adverse events (AEs). Our meta-analysis included 13 RCTs. Mean changes in the Liebowitz Social Anxiety Scale (LSAS) total score, fear and avoidance subscale of LSAS scores were all significantly greater in patients with SAD that received paroxetine compared to those received placebo (total: MD = 13.46, 95%CI 10.59-16.32, P < .00001; fear: MD = 6.76, 95%CI 4.89-8.62, P < .00001; avoidance: MD = 6.54, 95%CI 4.63-8.45, P < .00001). Response and remission rates were both significantly greater in patients with SAD that received paroxetine compared to those received placebo (response: OR = 3.02, 95%CI 2.30-3.97, P < .00001; remission: OR = 3.14, 95%CI 2.25-4.39, P < .00001). There was no significant difference in discontinuation rate due to any reason between two groups (OR = 1.06, 95%CI 0.81-1.39, P = .65). Discontinuation rate due to AEs was higher in paroxetine than placebo group (OR = 3.41, 95%CI 2.45-4.72, P < .00001) whereas the rate due to lack of efficacy was higher in placebo as compared with paroxetine group (OR = 0.14, 95%CI 0.09-0.22, P < .00001). The incidence of any AE was significantly increased in patients that received paroxetine (OR = 1.83, 95%CI 1.43-2.35, P < .00001). Paroxetine was an effective and well-tolerated treatment option for adult patients with SAD.

New Gambling Task Reveals an Atypical Relation Between Social Anxiety and Social Avoidance in Schizophrenia

Abstract A core symptom of schizophrenia is a deficit in social cognition. Furthermore, many patients suffer from relevant social anxiety. How social anxiety relates to social avoidance in schizophrenia is, however, still unclear. To address this question empirically, 30 participants with schizophrenia were compared to individually matched controls in a recently developed experimental task. In each trial, participants chose between a monetary gamble with a human partner providing social feedback and a defined monetary amount that varied across trials. The tendency to avoid the interaction under acceptance of monetary loss served as a measure of social avoidance. Patients showed higher levels of social anxiety assessed using the Liebowitz Social Anxiety Scale (LSAS) than controls, took longer to decide whether to engage in the social interaction and rated social feedback as less intense. Despite making rational decisions, patients surprisingly showed no social avoidance. We assume that the lack of experimentally induced social avoidance in contrast to the well-known social avoidance behavior in everyday life, also reflected by elevated self-rated LSAS scores, was due to a partial compensation of delayed social information processing in the absence of the time constraints in our task. This additional time may have allowed rational decisions and masked potential social avoidance behavior. We conclude that social anxiety in schizophrenia may have different characteristics than in individuals without schizophrenia, namely avoidance of negative feedback caused by prolonged social processing instead of fear of supposed negative feedback. Treatment strategies for social anxiety in schizophrenia may benefit from considering these differences.

The long-term effects of microvascular decompression on social phobia and health-related quality of life in patients with hemifacial spasm: a 3-year prospective study.

Although not a life-threatening condition, hemifacial spasm (HFS) frequently leads to social phobia because it causes significant facial disfigurement and consequently reduces health-related quality of life (HRQoL). The purpose of the current study was to examine the long-term effects of MVD on psychological aspects and HRQoL in HFS patients with social anxiety over a 36-month follow-up. Thirty patients with HFS who underwent MVD from January 2015 to May 2015 were included in this prospective study. Clinical data, including standardized measures of general anxiety and depression (Hospital Anxiety Depression Scale (HADS)), social anxiety (Liebowitz Social Anxiety Scale (LSAS)), and the severity of HFS, were collected postoperatively, and 6months and 36months after MVD. Likewise, data on HRQoL were collected at baseline, and 6months and 36months after MVD using the Korean version of the Short Form 36 (SF-36). Twenty-two patients who completed the 36-month follow-up were classified into social phobia group and non-social phobia group based on the LSAS total scores of 60. Repeated measures analysis of variance demonstrated significant differences between the two groups over time for the total LSAS score (p < 0.001), anxiety subscale score of the HADS (p = 0.002), and the Mental Component Summary (MCS) (p = 0.046) of the SF-36. A comparison of these two groups in terms of differences observed in their scales at 6months after MVD has shown that the improvements of the social phobia group in HADS anxiety subscale (p = 0.010), LSAS total score (p = 0.008), and MCS (p = 0.040) were significantly more improved than the those of non-social phobia group. And at 36months after surgery, the improvement of the scales mentioned above was maintained, and additionally Vitality (p = 0.040) and Mental Health (p = 0.040) dimensions showed a statistically significant improvement. The improvements previously observed in psychological aspects and HRQoL over a short-term follow-up after MVD in HFS patients with social phobia were maintained for at least 36months after MVD.

Comparison of Quality of Life, Depression, Anxiety, Suicide, Social Anxiety and Obsessive-Compulsive Symptoms Between Adolescents with Acne Receiving Isotretinoin and Antibiotics: A Prospective, Non-randomised, Open-Label Study.

The effects of isotretinoin on suicide, social anxiety and obsessive-compulsive symptoms in adolescents with acne have not been sufficiently investigated. This study aimed to evaluate the quality of life, depression, anxiety, suicide, social anxiety, and obsessive-compulsive symptoms of adolescents receiving systemic isotretinoin and antibiotic treatments at baseline and at 3months. The study included a total of 102 adolescents using isotretinoin (n = 60) and antibiotics (n = 42). The Acne Quality of Life Scale (AQLS), Hospital Anxiety and Depression Scale (HADS), Suicide Probability Scale (SPS), Liebowitz Social Anxiety Scale (LSAS), and Maudsley Obsessive-Compulsive Question List (MOCQL) were administered to both groups at baseline and at 3months. In order to exclude patients with comorbid psychiatric disorders, the patients were evaluated at the beginning of the study with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). There were no significant differences in the mean age, gender distribution, educational level, and family history of mental illness between the two groups. There were significant decreases in the Global Acne Grading System scores, visual analogue scale scores, AQLS scores, total and subscale scores of LSAS, and total and subscale scores of MOCQL at 3months compared with baseline in both groups. However, there were no significant changes in the total and subscale scores of HADS and total and subscale scores of SPS at 3months compared with baseline in both groups. We found that neither isotretinoin nor antibiotic treatment affected the levels of depression, anxiety, and suicide in acne patients. Moreover, both isotretinoin and antibiotic treatment were shown to improve the quality of life, social anxiety, and obsessive-compulsive symptoms in acne patients. However, clinicians should be careful about psychiatric side effects in patients using isotretinoin. Further studies with a larger number of cases and with a longer follow-up period are needed to investigate the complex effects of isotretinoin on the central nervous system.

Evaluation of the Effects of Periodontal Disease Severity on Social Anxiety Level

Objectives: The aim of this study was to determine the level of social anxiety in patients with periodontal disease, and to examine its relationship with the clinical characteristics of periodontal disease.Materials and Methods: This study investigated 200 patients in a cross-sectional design. Sociodemographic data, clinical periodontal parameters and patient complaints were recorded. Patients were divided into four groups according to their clinical periodontal index values: chronic periodontitis (CP), aggressive periodontitis (AP), gingivitis (G), and periodontally healthy (PH). Social anxiety levels of the patients were assessed based on the Liebowitz Social Anxiety Scale (LSAS).Results: A negative relationship was observed between LSAS scores and age, a positive relationship was observed with education level (p0.05). The Liebowitz total score and total anxiety, socially related anxiety and total avoidance levels of patients with halitosis complaints were found significantly higher (p0.05). LSAS scores for patients with complaints of aesthetics and mobility were significantly higher for all seven sub-items (p0.05). Total avoidance and performance avoidance values were significantly higher in patients with complaints of gingival bleeding (p0.05). All of the LSAS scores were higher in the AP and CP groups compared to the PH group and higher in the AP group than in the CP and G groups (p&amp;lt;0.05). In the G group, the performance-related avoidance level was significantly higher than in the PH group (p&amp;lt;0.05).

Evaluation of Social Anxiety Levels and Related Factors in Psoriasis Patients: A Controlled, Cross- Sectional Study

Psoriasis patients usually feel shame over their appearance and suffer from poor self-esteem, social anxiety, and avoidance. However, little is known about factors affecting social anxiety levels in these patients. We sought to examine the psychological, as well as disease-related factors which may affect social anxiety levels in psoriasis patients. Our study consisted of 50 psoriasis outpatients and a corresponding 50 age and sex-matched healthy control volunteers who filled out the Liebowitz Social Anxiety Scale (LSAS), the Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), Ways of coping questionnaire (WCQ) and Eysenck Personality Questionnaire Revised: abbreviated form (EPQR-A). The patients also completed the Dermatology Life Quality Index (DLQI). The extensiveness and severity of the disease were examined by employing the Psoriasis Area and Severity Index (PASI). Compared with our controls, psoriasis patients displayed significantly higher degrees of social anxiety. Both social fear⁄avoidance subscale scores of LSAS showed a significant correlation to impairment in quality of life (r: 0.373, p: 0.008, r: 0.336, p: 0.018). No appreciable correlation was observable among the PASI and LSAS scores. Regression analysis showed that EPQR-A-extraversion and neuroticism subscale scores had significant influence on LSAS-Social Anxiety scores, accounting for 41.5% of the variance. EPQR-A-extraversion was found to have significant influence on LSAS-Social avoidance scores, accounting for 26.8% of the variance. Our results indicate that psoriasis causes increased levels of social anxiety which is closely related to impaired quality of life. Personality characteristics might contribute considerably in expressing psychosocial morbidity among individuals living with psoriasis.