Differential Diagnosis of Social Phobia

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A. Substance-Induced Anxiety Disorder. Substances such as caffeine, amphetamines, cocaine, alcohol or benzodiazepines may cause a withdrawal syndrome that can mimic symptoms of social phobia

B. Obsessive-Compulsive Disorder, Specific Phobia, Hypochondriasis, or Anorexia Nervosa. Anxiety symptoms are common to many psychiatric disorders such as depression and the anxiety disorders. The diagnosis of social phobia should be made only if the anxiety is unrelated to another disorder. For example, social phobia should not be diagnosed in panic disorder if the patient has social restriction and excessive anxiety about having an attack.

C. Anxiety Disorder Due to a General Medical Condition. Hyperthyroidism and other medical conditions may produce significant anxiety, and should be ruled out. (See page 91)

D. Mood and Psychotic Disorders. Excessive social worry and anxiety can occur in many mood and psychotic disorders. If anxiety occurs only during the course of the mood or psychotic disorder, then social phobia should not be diagnosed.

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