Social anxiety disorder is among the most common and functionally impairing of the anxiety conditions. In the US, the 1-year point prevalence rate is approximately 7% and the estimated lifetime prevalence is around 12% to 13%.[2]Stein DJ, Lim CCW, Roest AM, et al. The cross-national epidemiology of social anxiety disorder: data from the World Mental Health Survey Initiative. BMC Med. 2017 Jul 31;15(1):143.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535284
http://www.ncbi.nlm.nih.gov/pubmed/28756776?tool=bestpractice.com
[5]Szuhany KL, Simon NM. Anxiety disorders: a review. JAMA. 2022 Dec 27;328(24):2431-45.
http://www.ncbi.nlm.nih.gov/pubmed/36573969?tool=bestpractice.com
Although it may develop at any time during a lifespan, the average age of onset tends to fall during late childhood and adolescence.[2]Stein DJ, Lim CCW, Roest AM, et al. The cross-national epidemiology of social anxiety disorder: data from the World Mental Health Survey Initiative. BMC Med. 2017 Jul 31;15(1):143.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535284
http://www.ncbi.nlm.nih.gov/pubmed/28756776?tool=bestpractice.com
[6]Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678
http://www.ncbi.nlm.nih.gov/pubmed/15939837?tool=bestpractice.com
The prevalence of social anxiety in pre-adolescence is 3.5%, with rates increasing to about 14% during adolescence.[6]Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678
http://www.ncbi.nlm.nih.gov/pubmed/15939837?tool=bestpractice.com
[7]Merikangas KR. Vulnerability factors for anxiety disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am. 2005 Oct;14(4):649-79;vii.
http://www.ncbi.nlm.nih.gov/pubmed/16171697?tool=bestpractice.com
Gender distribution tends to be generally equal during pre-adolescence, becoming increasingly more common in females than in males through adolescence and adulthood. Across cultures, girls are twice as likely to have social anxiety disorder compared with boys during adolescence, and rates are approximately 1.5 times higher among women compared with men in adulthood.[8]Asher M, Asnaani A, Aderka IM. Gender differences in social anxiety disorder: a review. Clin Psychol Rev. 2017 Aug;56:1-12.
http://www.ncbi.nlm.nih.gov/pubmed/28578248?tool=bestpractice.com
An estimated 70% to 80% of individuals with social anxiety disorder have concurrent anxiety, mood, and substance-use related disorders.[1]Fehm L, Wittchen HU. Comorbidity in social anxiety disorder. In: Bandelow B, Stein DJ, eds. Social anxiety disorder. New York, NY: Marcel Dekker; 2004:49-63.[2]Stein DJ, Lim CCW, Roest AM, et al. The cross-national epidemiology of social anxiety disorder: data from the World Mental Health Survey Initiative. BMC Med. 2017 Jul 31;15(1):143.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535284
http://www.ncbi.nlm.nih.gov/pubmed/28756776?tool=bestpractice.com
Minoritized individuals may be particularly vulnerable to social anxiety given higher rates of rejection, exclusion, bullying, and violence relative to majority populations.[9]Busa S, Wernick J, Kellerman J, et al. A descriptive case study of a cognitive behavioral therapy group intervention adaptation for transgender youth with social anxiety disorder. Behav Ther (N Y N Y). 2022 Apr;45(4):135-41.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236272
http://www.ncbi.nlm.nih.gov/pubmed/35765467?tool=bestpractice.com
The prevalence of social anxiety among gender dysphoric youth, for example, has been reported to be as high as 31.4%.[10]Bergero-Miguel T, García-Encinas MA, Villena-Jimena A, et al. Gender dysphoria and social anxiety: an exploratory study in Spain. J Sex Med. 2016 Aug;13(8):1270-8.
http://www.ncbi.nlm.nih.gov/pubmed/27319274?tool=bestpractice.com
Rates of social anxiety disorder among other developed countries are similar to those in the US.[11]Stein MB, Stein DJ. Social anxiety disorder. Lancet. 2008 Mar 29;371(9618):1115-25.
http://www.ncbi.nlm.nih.gov/pubmed/18374843?tool=bestpractice.com
Worldwide, prevalence rates are lower in low- and middle-income countries and in the African and Eastern Mediterranean regions, and are higher in high-income countries and in the Americas and Western Pacific regions. However, certain patterns - including early onset, impairment in multiple domains, and associated psychiatric comorbidities - appear to be globally consistent.[2]Stein DJ, Lim CCW, Roest AM, et al. The cross-national epidemiology of social anxiety disorder: data from the World Mental Health Survey Initiative. BMC Med. 2017 Jul 31;15(1):143.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535284
http://www.ncbi.nlm.nih.gov/pubmed/28756776?tool=bestpractice.com
Cultural variants of social anxiety are present in Asian and Eastern cultures, and may involve fears such as offending others or making others uncomfortable. Cross-cultural variations in anxiety presentation should be carefully assessed.[12]Carter MM, Mitchell FE, Sbrocco T. Treating ethnic minority adults with anxiety disorders: current status and future recommendations. J Anxiety Disord. 2012 May;26(4):488-501.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913267
http://www.ncbi.nlm.nih.gov/pubmed/22417877?tool=bestpractice.com